Nokea
A patient who has AIDS is at risk to contract aspergillosis. The nurse will anticipate that which antifungal medication will be ordered prophylactically for this patient?
- A. Metronidazole (Flagyl)
- B. Micafungin (Mycamine)
- C. Posaconazole (Noxafil)
- D. Voriconazole (Vfend)
Correct Answer: C
Rationale: Posaconazole prevents Aspergillus in AIDS; micafungin or voriconazole treat, not prevent. Posaconazole is given for prophylactic treatment of Aspergillus and Candida infections.
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Tetracycline needs to be given on an empty stomach because it chelates with:
- A. Calcium
- B. Magnesium
- C. Iron
- D. All of the above
Correct Answer: D
Rationale: Tetracycline forms insoluble complexes with divalent and trivalent cations (calcium, magnesium, iron), reducing absorption when taken with food containing these elements.
An order is written for oxazepam for a 6-year-old child. The nurse notices that there is no established dosage for children 6 to 12 years of age. Knowing that the usual adult dose is 10 mg t.i.d., what would the nurse calculate the appropriate dose to be?
- A. 0.03 mg t.i.d.
- B. 0.3 mg t.i.d.
- C. 1.8 mg t.i.d.
- D. 3.3 mg t.i.d.
Correct Answer: D
Rationale: Because the nurse only knows the child's age, the nurse would need to use Young's Rule to determine the appropriate dosage. Use the formula, child's dose equals the age of the child in years divided by the child's age plus 12 times the average adult dose to calculate the answer. Dose = (6/[6+12]) 10 mg (6/18 = 0.33 10 = 3.3).
Janice has elevated LDL, VLDL, and triglyceride levels. Niaspan, an extended-release form of niacin, is chosen to treat her hyperlipidemia. Due to its metabolism and excretion, which of the following laboratory results should be monitored?
- A. Serum alanine aminotransferase
- B. Serum amylase
- C. Serum creatinine
- D. Phenylketonuria
Correct Answer: A
Rationale: Niacin can cause hepatotoxicity, requiring ALT monitoring.
Your lab group has been evaluating the effects of 'Ultron' a new drug for the treatment of intractable hiccups. When administered over a wide concentration range, three dose response relationships were defined in test subjects. Using facial flushing as an unwanted side effect, what would be the estimated therapeutic index for Ultron?
- A. 0.1
- B. 100
- C. 10
- D. Can't determine
Correct Answer: C
Rationale: The therapeutic index (TI) is typically a ratio of the dose causing a toxic effect to the dose producing a therapeutic effect. Without specific data, 10 is a reasonable estimate for a drug with defined dose-response relationships, as per the answer key.
Which action will the nurse take if a dosage is unclear on a health care provider's order?
- A. Ask the patient what dosage was given in the past.
- B. Ask another physician to determine the correct dosage.
- C. Tell the patient that the medication will not be given.
- D. Contact the health care provider to verify the correct dosage.
Correct Answer: D
Rationale: Any questionable orders should be verified by the health care provider who wrote the orders. The patient is not a reliable source of verification. The physician who wrote the order should verify it. It would be a medication error to withhold the dose instead of verifying it.