Nokea
A nursing instructor is observing a nursing student prepare an oral drug for administration. The instructor determines that the student is performing the procedure correctly when the student compares the label of the drug with the MAR how many times?
- A. 2
- B. 3
- C. 4
- D. 5
Correct Answer: B
Rationale: The proper procedure is to compare the drug label with the MAR three times: when the drug is taken from its storage area, immediately before removing the drug from the container, and before administering the drug to the patient.
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A 75-year-old woman with diabetes is taking an oral antidiabetic drug. One day she goes without eating for 18 \mathrm{~h}. Her serum glucose concentration is 48 \mathrm{mg} / \mathrm{dL} (hypoglycemic) upon arrival at the emergency department, where she is deemed to be in critical condition. Which of the following drugs most likely aggravated this fasting hypoglycemia?
- A. Acarbose
- B. Glyburide
- C. Metformin
- D. Pioglitazone
Correct Answer: B
Rationale: Glyburide, a sulfonylurea, can cause severe hypoglycemia, especially during fasting, due to prolonged insulin release.
Which advantage(s) does the unit dose drug distribution system include? (Select one that does not apply.)
- A. Credit is given to the patient for unused medications.
- B. The pharmacist is able to analyze prescribed medications for each client for drug interactions and contraindications.
- C. There is less waste of medications.
- D. The time spent by nursing personnel preparing these medications is increased.
Correct Answer: D
Rationale: Because the pharmacist has a profile of all medications for each patient, he or she is able to analyze prescribed medications for each patient for drug interactions and contraindications. This is an advantage of the unit dose drug distribution system. Less waste of medications is an advantage of the unit dose drug distribution system. Because each dose is individually packaged, credit can be given to the patient for unused medications. There is increased pharmacist involvement and better use of his or her extensive drug knowledge and nursing personnel time is decreased with this method.
The nurse is caring for a patient who is chronically irritable and anxious and prone to violent behaviors. The patient has several teeth missing and has dental caries in the remaining teeth. The nurse suspects previous chronic use of which drug?
- A. Alcohol
- B. Cocaine
- C. LSD
- D. Methamphetamine
Correct Answer: D
Rationale: Methamphetamine causes tooth decay ('meth mouth') and agitation; cocaine less so. Patients previously exposed to methamphetamine use will exhibit these symptoms, and the physical effects of extended methamphetamine use are notable tooth decay and dermatologic deterioration.
Nicotine gum products are:
- A. Chewed to release the nicotine and then swallowed for a systemic effect
- B. Parked' in the buccal area of the mouth to produce a constant amount of nicotine release
- C. Bound to exchange resins so the nicotine is only released during chewing
- D. Approximately the same in nicotine content as smoking two cigarettes
Correct Answer: B
Rationale: Nicotine gum is parked buccally for steady release.
A nurse is assessing a male client who recently began taking Haloperidol. Which of the following findings is the highest priority to report to the provider?
- A. Shuffling gait
- B. Neck spasms
- C. Drowsiness
- D. Impotence
Correct Answer: B
Rationale: Neck spasms indicate dystonia, an acute extrapyramidal symptom requiring immediate attention.