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A patient is being treated with isoniazid (INH), rifampin, and pyrazinamide in phase I of treatment for tuberculosis. The organism develops resistance to isoniazid. Which drug will the nurse anticipate the provider will order to replace the isoniazid?
- A. Ciprofloxacin (Cipro)
- B. Ethambutol (Myambutol)
- C. Kanamycin
- D. Streptomycin sulfate
Correct Answer: B
Rationale: Ethambutol replaces INH in phase I if resistance occurs; ciprofloxacin or kanamycin are less common first-line options. If there is bacterial resistance to isoniazid, the first phase may be changed to ethambutol, rifampin, and pyrazinamide.
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When recommending dimenhydrinate (Dramamine) to treat motion sickness, patients should be instructed to:
- A. Take the dimenhydrinate after they get nauseated
- B. Drink lots of water while taking the dimenhydrinate
- C. Take the dimenhydrinate 15 minutes before it is needed
- D. Double the dose if one tablet is not effective
Correct Answer: C
Rationale: Dimenhydrinate is most effective taken 15-30 minutes before motion to prevent nausea; post-nausea , hydration , or doubling are less optimal.
A nursing student is reviewing information about the Controlled Substances Act of 1970. The student would expect to find which of the following as being regulated for drugs classified as controlled substances? Select one that does not apply
- A. Manufacturing
- B. Elimination
- C. Distribution
- D. Dispensing the drug
Correct Answer: B
Rationale: The Controlled Substances Act of 1970 regulates the manufacture, distribution, and dispensing of drugs classified as controlled substances. Elimination refers to the excretion of drugs from the body, a pharmacokinetic activity. The act does not address formulation of the drug.
Jake, a 45-year-old patient with schizophrenia, was recently hospitalized for acute psychosis due to medication noncompliance. He was treated with IM long-acting haloperidol. Besides monitoring his schizophrenia symptoms, the patient should be assessed by his primary care provider:
- A. For excessive weight loss
- B. With the Abnormal Involuntary Movement Scale (AIMS) for extrapyramidal symptoms (EPS)
- C. Monthly for tolerance to the haloperidol
- D. Only by the mental health provider, as most NPs in primary care do not care for mentally ill patients
Correct Answer: B
Rationale: Haloperidol can cause EPS, monitored using the AIMS.
A patient arrives in the emergency department in an acute state of alcohol intoxication and reports chronic consumption of several six packs of beer every day for the past year. The nurse anticipates administering which medication or treatment?
- A. Chlordiazepoxide (Librium)
- B. Disulfiram (Antabuse)
- C. Gastric lavage
- D. Vasoconstrictors
Correct Answer: A
Rationale: Chlordiazepoxide prevents alcohol withdrawal symptoms; disulfiram is post-detox. To prevent acute withdrawal and delirium tremens, a long-acting benzodiazepine, such as chlordiazepoxide, is given.
Oral iron supplements are prescribed for a 6 year-old child with iron deficiency anemia. The nurse instructs the mother to administer the iron with which best food item?
- A. Milk
- B. Water
- C. Apple juice
- D. Orange juice
Correct Answer: D
Rationale: Vitamin C increases the absorption of iron by the body. The mother should be instructed to administer the medication with a citrus fruit or a juice that is high in vitamin C. Milk may affect absorption of the iron. Water will not assist in absorption. Orange juice contains a greater amount of vitamin C than apple juice.