Nokea
A patient with Cushing's syndrome is being treated by X-irradiation of the pituitary. It may take several months of treatment for adequate symptomatic and metabolic improvement. Until that time, which of the following might be administered adjunctively to suppress glucocorticoid synthesis?
- A. Cimetidine
- B. Cortisol (massive doses)
- C. Fludrocortisone
- D. Ketoconazole
Correct Answer: D
Rationale: Ketoconazole inhibits adrenal steroidogenesis, reducing glucocorticoid levels in Cushing's syndrome.
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The type of adverse drug reaction that is idiosyncratic when a drug given in the usual therapeutic doses is type:
- A. A
- B. B
- C. C
- D. D
Correct Answer: B
Rationale: Type B reactions are idiosyncratic, unpredictable responses to normal doses, unlike dose-related Type A or chronic Type C/D.
A nurse is caring for an older adult client in a long-term care facility who has Hypothyroidism and a new prescription for Levothyroxine. Which of the following dosage schedules should the nurse expect for this client?
- A. The client will remain 0.1 mg dose, and the dose will be 0.1 mg of 0.1 mg dose, and the dose will be... (truncated)
Correct Answer: A
Rationale: Older adults typically start with a low dose (e.g., 0.025-0.05 mg) of levothyroxine, titrated slowly; 0.1 mg is plausible with adjustment.
Who defines the standards of care for the practice of nursing? (Select one that does not apply.)
- A. State boards of nursing
- B. Hospital policy and procedures
- C. Federal laws regulating health care facilities
- D. The Joint Commission
Correct Answer: B
Rationale: Standards of care are defined by state boards of nursing, federal laws regulating health care facilities, The Joint Commission, and professional nursing associations such as the American Nurses Association. Individual hospital policies and procedures incorporate federal and state guidelines into their respective policies and procedures and are often more stringent than state and federal regulations.
While collecting a medication history, the patient admits to doubling the recommended dosage of an over-the-counter (OTC) medication, saying its harmless or they would require a prescription. What is the nurses best response?
- A. OTC drugs are serious medications and carry serious risks if not taken as directed.
- B. Taking medications like that is careless and you could kill yourself doing it.
- C. Sometimes you need to take more than the package directs to treat the symptoms.
- D. Did you notify your doctor of the increased dosage you were taking?
Correct Answer: A
Rationale: OTC drugs are no less a medication than prescription drugs and carry the same types of risks for overdosage and toxicity if directions are not followed. Although increasing the dosage is careless and dangerous, it is important to use the information as a teaching opportunity rather than scolding the patient. Agreeing with the patient or asking her if she talked to the doctor misses the teaching opportunity, which could be harmful for the patient.
A drug may be classified by which of the following? Select one that does not apply.
- A. The chemical type of the drug's active ingredient
- B. The way the drug is seen
- C. The generic name of the drug
- D. The trade name of the drug
Correct Answer: A
Rationale: A drug may be classified by the chemical type of the active ingredient or by the way it is used to treat a particular condition. Generic, trade, and nonproprietary refer to how a drug is named.