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A patient takes an oral medication that causes gastrointestinal upset. The patient asks the primary care NP why the drug information insert cautions against using antacids while taking the drug. The NP should explain that the antacid may:
- A. alter drug absorption.
- B. alter drug distribution.
- C. lead to drug toxicity.
- D. increase stomach upset.
Correct Answer: A
Rationale: The correct answer is A because antacids change gastric pH, affecting drug absorption. Choice B is incorrect as distribution isn’t directly altered. Choice C is wrong since toxicity isn’t the primary concern here. Choice D is inaccurate as antacids typically reduce upset.
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The client has been prescribed atorvastatin (Lipitor) for hyperlipidemia. Which instruction should the nurse provide to the client?
- A. Take the medication in the morning with breakfast.
- B. Avoid drinking grapefruit juice while taking this medication.
- C. Increase your intake of dietary fiber while on this medication.
- D. Avoid eating foods high in potassium.
Correct Answer: B
Rationale: The correct instruction for the nurse to provide to the client prescribed atorvastatin (Lipitor) for hyperlipidemia is to avoid drinking grapefruit juice while taking this medication. Grapefruit juice can interfere with the metabolism of atorvastatin, leading to an increased risk of side effects. It is crucial for the client to adhere to this instruction to ensure the effectiveness and safety of the treatment. Choices A, C, and D are incorrect because taking the medication with breakfast, increasing dietary fiber intake, and avoiding foods high in potassium are not specific instructions related to atorvastatin therapy for hyperlipidemia.
The healthcare provider is teaching a client with hypertension about lifestyle modifications. Which recommendation should the healthcare provider include?
- A. Limit alcohol consumption to one drink per day.
- B. Increase sodium intake to maintain blood pressure.
- C. Exercise vigorously for at least 30 minutes daily.
- D. Avoid high potassium foods like bananas.
Correct Answer: A
Rationale: Limiting alcohol intake is an essential lifestyle modification recommended for managing hypertension. Excessive alcohol consumption can raise blood pressure, so limiting it to one drink per day is beneficial in controlling hypertension. Alcohol moderation is a key part of a heart-healthy lifestyle for individuals with high blood pressure. Choice B is incorrect because increasing sodium intake can actually worsen hypertension by retaining water and increasing blood pressure. Choice C is incorrect because while exercise is important for overall health, moderate-intensity exercise is recommended for individuals with hypertension to avoid excessive strain on the heart. Choice D is incorrect because high potassium foods like bananas are actually beneficial for individuals with hypertension as they can help lower blood pressure.
A healthcare professional is preparing to administer ceftriaxone 1 g IM to a client who has a pelvic infection. Which of the following actions should the healthcare professional plan to take?
- A. Administer the medication via IM bolus over 5 minutes.
- B. Reconstitute with 0.9% sodium chloride.
- C. Discard the reconstituted medication if it is cloudy.
- D. Administer the medication in a large muscle.
Correct Answer: D
Rationale: Administering ceftriaxone in a large muscle is crucial for proper absorption and to reduce the risk of pain or tissue irritation. Intramuscular administration of ceftriaxone helps achieve optimal therapeutic levels in the bloodstream for the treatment of the pelvic infection. Choices A, B, and C are incorrect. Choice A is not recommended as ceftriaxone should not be administered as a bolus over 5 minutes. Choice B is irrelevant because the question is about the administration route, not the reconstitution process. Choice C is also irrelevant as it does not pertain to the administration but to the quality of the reconstituted medication.
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.
Strategies to prevent misuse of prescription drugs include:
- A. Using prescription drug monitoring programs
- B. Educating patients about risks
- C. Prescribing the lowest effective dose
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because PDMPs track dispensing, education deters misuse, and lowest doses minimize excess—all proven prevention methods. Choice A is incorrect alone as it's one tool. Choice B is wrong by itself because education is just part. Choice C is incorrect solo since dosing is only one strategy.