Nokea
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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A nurse is required to give an intramuscular (IM) injection to an 18-month-old toddler. The nurse would prepare which site for administration?
- A. Dorsogluteal site
- B. Deltoid muscle
- C. Vastus lateralis
- D. Ventrogluteal site
Correct Answer: C
Rationale: The vastus lateralis site is frequently used for infants and small children because it is more developed than the other intramuscular sites such as the dorsogluteal and deltoid muscle. Ventrogluteal sites may be used in children who have been ambulating for more than 2 years.
Patients who have a poor metabolism phenotype will have:
- A. Slowed metabolism of a prodrug into an active drug, leading to accumulation of prodrug
- B. Accumulation of inactive metabolites of drugs
- C. A need for increased dosages of medications
- D. Increased elimination of an active drug
Correct Answer: A
Rationale: Poor metabolizers (e.g., CYP2D6) slowly convert prodrugs to active forms , causing prodrug buildup, not metabolite accumulation or faster elimination .
When writing a prescription for warfarin it is common to write ____ on the prescription.
- A. OK to substitute for generic
- B. The brand name of warfarin and Do Not Substitute
- C. PRN refills
- D. Refills for 1 year
Correct Answer: B
Rationale: Brand-specific warfarin ensures consistent potency; generics vary slightly, and PRN or yearly refills are impractical.
What is the most likely mechanism for hip fracture in patients with glucocorticoid longterm treatment?
- A. Increased intestinal calcium absorption
- B. Increased sex hormone synthesis
- C. Inhibition of bone formation
- D. Osteoarthritis
Correct Answer: C
Rationale: Glucocorticoids inhibit bone formation by suppressing osteoblast activity, increasing osteoporosis and fracture risk.
Pregnant women should receive the Tdap vaccine:
- A. In the first trimester
- B. Once every 10 years
- C. In the third trimester of every pregnancy
- D. Tdap is contraindicated in pregnancy
Correct Answer: C
Rationale: Tdap in the third trimester protects newborns from pertussis; it's not contraindicated or trimester-specific otherwise.