Nokea
A nursing student is preparing to administer a prescribed drug to a patient. The student reviews information about the drug and its actions. Which of the following would be the best choice for obtaining this information?
- A. Nursing instructor
- B. Nurse assigned to the patient
- C. Clinical drug reference
- D. Prescribing health care provider
Correct Answer: C
Rationale: Although the nursing student can ask the nursing instructor, the nurse assigned to the patient, and the prescribing health care provider for information about the drug, the best choices for drug information would include an appropriate drug reference and the clinical pharmacist.
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Direct renin inhibitors have the following properties. They:
- A. Are primarily generic drugs
- B. Are a renin-angiotensin-aldosterone system (RAAS) medication that is safe during pregnancy
- C. Can be used with an angiotensin-converting enzyme and angiotensin II receptor blocker medications for stronger impact
- D. Shut down' the entire RAAS cycle
Correct Answer: C
Rationale: Direct renin inhibitors (e.g., aliskiren) can be combined with ACEIs or ARBs for enhanced RAAS blockade.
Effects of glucagon are:
- A. Positive inotropic and chronotropic effects
- B. Negative inotropic and chronotropic effects
- C. Inhibition of Gs protein and decrease of CAMP
- D. Activation of Gq and accumulation of Inositol triphosphate
Correct Answer: A
Rationale: Glucagon has positive inotropic and chronotropic effects on the heart, increasing contractility and rate.
A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections. Which information should the nurse teach when carrying out plans for discharge?
- A. Keep insulin vials refrigerated at all times.
- B. Rotate the insulin injections systematically.
- C. Increase the amount of insulin before unusual exercise.
- D. Monitor the urine acetone level to determine the insulin dosage.
Correct Answer: B
Rationale: Insulin dosages should not be adjusted or increased before unusual exercise. If acetone is found in the urine, it may possibly indicate the need for additional insulin. To minimize the discomfort associated with insulin injections, the insulin should be administered at room temperature. Injection sites should be systematically rotated from one area to another. The client should be instructed to give injections in one area, about 1 inch apart, until the whole area has been used and then to change to another site. This prevents dramatic changes in daily insulin absorption.
The following drugs reduce mortality in congestive cardiac failure EXCEPT:
- A. Captopril
- B. Carvedilol
- C. Digoxin
- D. Enalapril
Correct Answer: C
Rationale: Digoxin improves symptoms but does not reduce mortality in heart failure.
Harold, a 42-year-old African American, has moderate persistent asthma. Which of the following asthma medications should be used cautiously, if at all?
- A. Betamethasone, an inhaled corticosteroid
- B. Salmeterol, an inhaled long-acting beta-agonist
- C. Albuterol, a short-acting beta-agonist
- D. Montelukast, a leukotriene modifier
Correct Answer: B
Rationale: Salmeterol carries a Black Box Warning for increased asthma-related deaths, especially in African Americans, requiring caution; others are safer.