A patient is brought to the emergency department by a family member. The patient reports seeing colored lights and describes feeling bugs crawling under the skin. The nurse suspects that this patient is abusing which drug?
- A. Alcohol
- B. Cocaine
- C. LSD
- D. Methamphetamine
Correct Answer: B
Rationale: Cocaine causes stimulant psychosis with visual (lights) and tactile (bugs) hallucinations; LSD differs in effect. A stimulant psychosis can occur with chronic use of any stimulant and, with cocaine, progresses to visual hallucinations of colored lights and tactile hallucinations of bugs crawling under the skin.
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Which of the following reflects a nurse's responsibility when a drug is prescribed for a client? (Select one that does not apply.)
- A. Administering the drug to the client
- B. Monitoring for therapeutic response
- C. Checking for drug-drug interactions
- D. Reporting adverse reactions
Correct Answer: C
Rationale: When a drug is prescribed to a client, the nurse is responsible for the administration of the drug, monitoring for therapeutic effects, reporting adverse drug reactions, and teaching the client information needed to administer the drug safely at home. A pharmacist checks for drug-drug interactions prior to dispensing a drug for administration.
Renal damage is a potential adverse effect of aminoglycosides. In what part of the kidney are aminoglycosides retained which causes this effect?
- A. Distal tubule
- B. Proximal tubule
- C. Loop of Henle
- D. Glomerulus
Correct Answer: B
Rationale: Aminoglycosides are nephrotoxic and accumulate in the proximal tubule, leading to cellular damage and potential renal impairment.
Prescribing less-expensive generic drugs or drugs off the 4 retail pharmacy lists:
- A. Increases the complexity of the pharmacoeconomics of prescribing for the individual patient
- B. Increases compliance by reducing the financial burden of drug costs to the patient
- C. Is not sound prescribing practice due to the inferiority of the generic products
- D. Will increase the overall cost of drugs to the system due to the ease of overprescribing less-expensive drugs
Correct Answer: B
Rationale: Generic drugs improve adherence by lowering patient costs.
The patient is a 6-year-old child who is taking 125 mg of amoxicillin every 6 hours. Assuming that the half-life of Amoxicillin is 3 hours, how much Amoxicillin would be in the child's body at the time of the next administration of the drug?
- A. 62.5 mg
- B. 46.875 mg
- C. 31.25 mg
- D. 15.625 mg
Correct Answer: C
Rationale: The half-life of a drug is the time it takes for the amount of drug in the body to decrease to 1 half the peak level it previously achieved. Option A would occur at 3 hours after the original dose of amoxicillin. Option B would occur 4½ hours after the original dose. Option C would occur at 6 hours after the original dose. Option D would occur at 7½ hours after the original dose.
Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. A nurse reviews the client's medical record and would question the prescription if which of the following is noted in the client's history?
- A. Neuralgia
- B. Insomnia
- C. Use of nitroglycerin
- D. Use of multivitamins
Correct Answer: C
Rationale: Sildenafil (Viagra) enhances the vasodilating effect of nitric oxide in the corpus cavernosum of the penis, thus sustaining an erection. Because of the effect of the medication, it is contraindicated with concurrent use of organic nitrates and nitroglycerin. Sildenafil is not contraindicated with the use of vitamins. Neuralgia and insomnia are side effects of the medication.
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