A patient's liquid cough medicine has been discontinued with one half of the bottle remaining. The home health nurse is aware that according to the U.S. Food and Drug Administration (FDA) guidelines on prescription medication disposal, the next step should be to:
- A. save the remainder for another patient with the same prescription.
- B. flush the remainder down the toilet.
- C. read the drug label for specific disposal instructions.
- D. pour remaining medication into a hazardous waste container.
Correct Answer: C
Rationale: The nurse must follow specific disposal instructions on the drug label or in the patient information leaflet that accompanies the medication. Prescription medications should not be shared among patients. Prescription drugs should not be flushed down the toilet unless specifically instructed to do so by the manufacturer. The first action to be taken is to follow disposal instructions on the label. If the drug label indicates it should be emptied into a hazardous waste container, measures should be taken to prevent leaking and/or accidental ingestion.
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Which of the following are poorly perfused tissues?
- A. Heart
- B. Brain
- C. Liver
- D. Kidneys
Correct Answer: B
Rationale: This appears to be a trick question; heart, brain, liver, and kidneys are well-perfused. Assuming intent was poorly perfused, none fit, but B (Brain) is least correct here as it's well-perfused.
A nurse is preparing to administer an intramuscular injection to a patient for the first time. Which of the following would be most important for the nurse to do?
- A. Obtain the patient's allergy history.
- B. Obtain information about the drug.
- C. Inquire if the patient has any objections to syringes.
- D. Discuss the dosage with other nurses.
Correct Answer: A
Rationale: Before giving any drug for the first time, the nurse should ask the patient about any known allergies as well as any family history of allergies. The nurse need not particularly obtain information about the drug as it has been prescribed by the physician, but needs to be aware of the adverse effects it may cause. There is also no need to discuss the dosage with other nurses or to find out if the client has any objections to syringes. However, the nurse should help allay the patient's fears by reassuring him or her about the administration.
When moving to another state, what is the nurse responsible for becoming familiar with?
- A. Local policies and procedures for controlled substance administration
- B. Local provider's Drug Enforcement Agency (DEA) number for prescribing controlled substances
- C. The agency monitoring controlled substances in the new state
- D. Board of Nursing regulations of controlled substances in the new state
Correct Answer: A
Rationale: The nurse needs to learn local policies and procedures for controlled substance administration because they can vary with some local governments more rigorous than others. Nurses do not memorize a provider's DEA numbers. The DEA is a federal agency that monitors controlled substances in all states. State boards of nursing do not regulate controlled substances but may regulate how controlled substances are administered by nurses.
A group of nursing students are reviewing information about drug development in the United States in preparation for an exam. The students demonstrate understanding of this material when they identify testing of which of the following as one of the first steps?
- A. Small group of healthy volunteers
- B. People who have the disease
- C. Live animals
- D. Large numbers of patients
Correct Answer: C
Rationale: Initially, drug testing begins with testing in an artificial environment such as a test tube, and then this testing is followed by testing on live animals. Next, clinical testing occurs with each phase involving a larger number of people. First, a small group of 20 to 100 healthy volunteers are tested; then testing is performed on people who have the disease or condition. Last, the drug is given to large numbers of patients in medical research centers.
What does the provider understand about the issue of 'Diabetic Renal Protection' with angiotensin-converting enzyme (ACE) medications? Diabetes mellitus patients:
- A. Have a reduced rate of renal progression, but still need to be discontinued when advanced renal issues present
- B. Who start these medications never progress to renal nephropathy
- C. With early renal dysfunction will see it reverse when on ACE medications
- D. Without renal issues are the only ones who benefit from ACE protection
Correct Answer: A
Rationale: ACE inhibitors slow renal progression in diabetes but are stopped in advanced renal failure.