Nokea
A patient needs 500 mL of an infusion over 5 hours. The drop factor is 10 gtt/mL. Calculate the flow rate in drops per minute.
- A. 16.67 gtt/min
- B. 20 gtt/min
- C. 25 gtt/min
- D. 50 gtt/min
Correct Answer: B
Rationale: Flow rate = (500 mL 10 gtt/mL) ÷ (5 60) = 5,000 ÷ 300 = 16.67 gtt/min, rounded to 20 gtt/min.
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Digoxin is a drug that has been used to treat systolic heart failure for over 200 years. It has a therapeutic index value of 2. How many daily doses of digoxin will the average patient have to take at one time to have a 50:50 chance of developing toxic side effects?
- A. One
- B. Two
- C. I don't know
Correct Answer: B
Rationale: With a therapeutic index of 2, the toxic dose is twice the therapeutic dose. Taking two daily doses at once would reach this threshold, giving a 50:50 chance of toxicity.
Pharmacokinetics is:
- A. The study of biological and therapeutic effects of drugs
- B. The study of absorption, distribution, metabolism and excretion of drugs
- C. The study of mechanism of drugs
- D. The study of methods of new drug development
Correct Answer: B
Rationale: Pharmacokinetics focuses on how the body handles a drug, including absorption, distribution, metabolism, and excretion (ADME), distinguishing it from pharmacodynamics, which studies drug effects.
A nurse is planning to administer IV Alteplase to a client who is demonstrating manifestations of a massive Pulmonary Embolism. Which of the following interventions should the nurse plan to take?
- A. Administer IM Enoxaparin along with the Alteplase dose.
- B. Hold direct pressure on puncture sites for up to 30 min.
- C. Administer Aminocaproic acid IV prior to alteplase infusion.
- D. Prepare to administer Alteplase within 8 hr of manifestation onset.
Correct Answer: B
Rationale: Holding pressure prevents bleeding at puncture sites after alteplase, a thrombolytic.
All of following drugs are metabolized in body by acetylation except:
- A. INH
- B. Hydralazine
- C. Procainamide
- D. Dilantin
Correct Answer: D
Rationale: Dilantin (phenytoin) is metabolized by hydroxylation, not acetylation.
The nurse is talking with a group of nursing students who are doing clinical hours on the unit. A student asks if all intramuscular (IM) drugs are absorbed the same. What factor would the floor nurse tell the students to affect absorption of the IM administration of drugs?
- A. Perfusion of blood to the subcutaneous tissue
- B. Integrity of the mucous membranes
- C. Environmental temperature
- D. Blood flow to the gastrointestinal tract
Correct Answer: C
Rationale: A cold environmental temperature can cause blood vessels to vasoconstrict and decreases absorption or in a hot environment vasodilate and increase absorption of IM medications. Blood flow to the subcutaneous tissues interferes with subcutaneous injection and blood flow to the gastrointestinal (GI) tract causes alterations in absorption for oral medications. The condition of mucous membranes can interfere with sublingual (under the tongue) and buccal (in the cheek) administration of drugs.