Nokea
A patient is receiving digoxin as treatment for heart failure. Which of the following would be most important for the nurse to monitor to reduce the risk for toxicity?
- A. Seizure activity
- B. Drug blood level
- C. Urinary output
- D. Blood pressure
Correct Answer: B
Rationale: The nurse should monitor the patient's blood level of the drug to ensure that the level remains within the therapeutic range. Monitoring seizure activity, urination frequency, and blood pressure will not prevent toxicity. Seizure activity is unrelated to digoxin or heart failure.
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The nurse explains the Drug Enforcement Agencys (DEAs) schedule of controlled substances to the nursing assistant who asks, Do you ever get a prescription for Schedule I medications? What is the nurses best response?
- A. Schedule I medications have no medical use so they are not prescribed.
- B. Schedule I medications have the lowest risk for abuse and do not require a prescription.
- C. Schedule I medications are only prescribed in monitored units for patient safety.
- D. Schedule I medications are found in antitussives and antidiarrheals sold over the counter.
Correct Answer: A
Rationale: Schedule I medications have no medical use and are never prescribed. Schedule V medications have the lowest risk for abuse and are found mostly in antitussives and antidiarrheals but they are not sold over the counter.
The treatment of hyperlipidemia with gemfibrozil plus lovastatin is associated with a high risk of:
- A. Constipation
- B. Myopathy
- C. Hepatitis
- D. Thrombocytopenia
Correct Answer: B
Rationale: Combining gemfibrozil and statins increases the risk of myopathy due to elevated statin levels.
Dulcea has type 2 diabetes and a high triglyceride level. She has gemfibrozil prescribed to treat her hypertriglyceridemia. A history of which of the following might contraindicate the use of this drug?
- A. Reactive airway disease/asthma
- B. Inflammatory bowel disease
- C. Allergy to aspirin
- D. Gallbladder disease
Correct Answer: D
Rationale: Gemfibrozil increases gallstone risk, contraindicating its use in gallbladder disease.
Six-year-old Lucy has recently been started on ethosuximide (Zarontin) for seizures. She should be monitored for:
- A. Increased seizure activity, as this drug may auto-induce seizures
- B. Altered renal function, including renal failure
- C. Blood dyscrasias, which are uncommon but possible
- D. Central nervous system excitement, leading to insomnia
Correct Answer: C
Rationale: Ethosuximide can rarely cause blood dyscrasias, requiring monitoring.
The client with ovarian cancer is being treated with vincristine (Oncovin). The nurse monitors the client, knowing that which of the following indicates a side effect specific to this medication?
- A. Diarrhea
- B. Hair loss
- C. Chest pain
- D. Numbness and tingling in the fingers and toes
Correct Answer: D
Rationale: A side effect specific to vincristine is peripheral neuropathy, which occurs in almost every client. Peripheral neuropathy can be manifested as numbness and tingling in the fingers and toes. Depression of the Achilles tendon reflex may be the first clinical sign indicating peripheral neuropathy. Constipation rather than diarrhea is most likely to occur with this medication, although diarrhea may occur occasionally. Hair loss occurs with nearly all the antineoplastic medications. Chest pain is unrelated to this medication.