A patient who takes an oral sulfonylurea medication will begin taking fluconazole (Diflucan). The nurse will expect to monitor which lab values in this patient?
- A. Blood urea nitrogen (BUN) and creatinine
- B. Electrolytes
- C. Fluconazole levels
- D. Glucose
Correct Answer: D
Rationale: Fluconazole inhibits CYP450, increasing sulfonylurea levels and hypoglycemia risk; glucose monitoring is key. Patients taking sulfonylurea drugs may have altered serum glucose when taking antifungal medications.
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Which diuretic is classified as a thiazide?
- A. Furosemide
- B. Spironolactone
- C. Hydrochlorothiazide
- D. Mannitol
Correct Answer: C
Rationale: Hydrochlorothiazide is a thiazide diuretic, acting on the distal convoluted tubule, unlike furosemide (loop), spironolactone (potassium-sparing), or mannitol (osmotic).
Which is known as the fifth vital sign?
- A. Temperature
- B. Respirations
- C. Pain
- D. Pulse
Correct Answer: C
Rationale: Pain is known as the fifth vital sign.
The student nurses are learning to weigh patients and do vital signs. Weighing a client is a nursing intervention that is most important for what?
- A. Dosage calculation
- B. Assessing changes in fluid balance
- C. Assessing changes in nutritional status
- D. Caloric needs
Correct Answer: B
Rationale: Weighing assesses fluid balance changes, vital for adjusting drugs like diuretics in conditions such as CHF.
The nurse, assisting with Phase I drug studies, is talking with a woman who asks, Why can't I participate in this study? What would be the nurse's best response?
- A. Drugs pose a greater risk to women of reproductive age.
- B. Drugs are only tested on men because they are stronger.
- C. Women are more prone to adverse effects from medications.
- D. Drugs affect women differently than they affect women.
Correct Answer: A
Rationale: Phase I drug trials usually involve healthy male volunteers because chemicals may exert an unknown and harmful effect on ova in women which could result in fetal damage when the woman becomes pregnant. Drugs are tested on both men and women, but women must be fully informed of risks and sign a consent stating they understand the potential for birth defects. Women are not more prone to adverse effects of medications. Although some drugs may affect women differently than men, this is a rationale for why drugs need to be tested on women, not an explanation of why women are not included in a phase I study.
Drug levels should be monitored in the treatment of
- A. Diabetes
- B. Epilepsy
- C. Status Asthmatics
- D. Hypertension
Correct Answer: B
Rationale: Therapeutic drug monitoring is critical in epilepsy (e.g., phenytoin) due to narrow therapeutic ranges.