Nokea
A patient develops hepatotoxicity from chronic acetaminophen use. The primary care NP may recommend:
- A. milk thistle.
- B. chondroitin.
- C. coenzyme Q.
- D. glucosamine.
Correct Answer: A
Rationale: The correct answer is A because milk thistle protects the liver from hepatotoxins like acetaminophen. Choices B, C, and D are incorrect as they lack this hepatoprotective effect.
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Pharmacokinetic changes in women's bodies that affect drug dosing include:
- A. Increased body fat
- B. Increased glomerular filtration rate in pregnancy
- C. Decreased gastric emptying
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because increased body fat (alters distribution), higher GFR in pregnancy (increases clearance), and slower gastric emptying (affects absorption) all change pharmacokinetics, impacting dosing. Choice A is incorrect alone as fat is one change. Choice B is wrong by itself because GFR is just part. Choice C is incorrect solo since gastric emptying is only one factor.
The healthcare professional is assisting in the care of a client diagnosed with heart failure. The client is receiving furosemide (Lasix). Which laboratory value should the healthcare professional monitor most closely?
- A. Serum calcium
- B. Serum potassium
- C. Serum sodium
- D. Serum glucose
Correct Answer: B
Rationale: Furosemide is a loop diuretic that can lead to significant potassium loss, making it crucial to monitor the client's serum potassium levels. Hypokalemia (low potassium levels) can result from furosemide use, potentially leading to adverse effects such as cardiac dysrhythmias. Therefore, close monitoring of serum potassium levels is essential to prevent complications in clients receiving furosemide. Monitoring serum calcium, sodium, or glucose levels is not the priority when administering furosemide.
Which of the following patients would be at higher risk of experiencing adverse drug reactions (ADRs):
- A. A 32-year-old male
- B. A 22-year-old female
- C. A 3-month-old female
- D. A 48-year-old male
Correct Answer: C
Rationale: Choice C is correct because a 3-month-old female is at higher risk for ADRs due to immature liver and kidney function, reducing drug metabolism and excretion, increasing toxicity potential. Choice A is incorrect as a healthy 32-year-old male typically has mature systems. Choice B is wrong because a 22-year-old female also has developed metabolism. Choice D is incorrect since a 48-year-old male, unless compromised, has lower risk than an infant.
The client with heart failure is prescribed furosemide (Lasix). Which electrolyte imbalance is the nurse most likely to monitor for?
- A. Hyperkalemia
- B. Hypernatremia
- C. Hypokalemia
- D. Hyponatremia
Correct Answer: C
Rationale: The correct answer is C: Hypokalemia. Furosemide, a loop diuretic, commonly causes potassium loss, leading to hypokalemia. The nurse should closely monitor for decreased potassium levels in a client receiving furosemide to prevent complications such as cardiac arrhythmias or muscle weakness. Hyperkalemia (Choice A) is not typically associated with furosemide use. Hypernatremia (Choice B) refers to high sodium levels and is not the primary concern with furosemide. Hyponatremia (Choice D) is low sodium levels, which can occur but is less common than hypokalemia in clients taking furosemide.
To reduce medication errors, the Institute of Safe Medication Practices recommends:
- A. Using only brand names on prescriptions
- B. Avoiding the use of 'tall man' lettering
- C. Avoiding the use of error-prone abbreviations
- D. Using decimals instead of fractions when prescribing
Correct Answer: C
Rationale: Choice C is correct because the ISMP recommends avoiding error-prone abbreviations (e.g., ‘U' for units) to prevent misinterpretation and errors, a proven safety strategy. Choice A is incorrect as brand names alone don't reduce errors—generics are standard. Choice B is wrong because ‘tall man' lettering (e.g., LisinOPRIL) helps, not harms. Choice D is incorrect since decimals can confuse (e.g., .5 vs. 0.5)—whole numbers are safer.