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A pharmacology student asks the instructor what an accurate description of a drug agonist is. What is the instructors best response?
- A. A drug that reacts with a receptor site on a cell preventing a reaction with another chemical on a different receptor site
- B. A drug that interferes with the enzyme systems that act as catalyst for different chemical reactions
- C. A drug that interacts directly with receptor sites to cause the same activity that a natural chemical would cause at that site
- D. A drug that reacts with receptor sites to block normal stimulation, producing no effect
Correct Answer: C
Rationale: Agonists are drugs that produce effects similar to those produced by naturally occurring neurotransmitters, hormones, or other substances found in the body. Noncompetitive antagonists are drugs that react with some receptor sites preventing the reaction of another chemical with a different receptor site. Drug-enzyme interactions interfere with the enzyme systems that stimulate various chemical reactions.
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When administering a prescribed drug to a client, which action would be completely inappropriate? (Select one that does not apply.)
- A. Charting immediately on the MAR after drug administration
- B. Removing a drug from an unlabeled container
- C. Giving a drug that someone else prepared
- D. Crushing tablets or opening capsules
Correct Answer: A
Rationale: The nurse should always record immediately on the MAR after drug administration. The nurse should never remove a drug from an unlabeled container, give a drug that someone else prepared, or crush tablets or open capsules without consulting a pharmacist. The drug's unit dose wrapper should remain on until the nurse arrives at the client's bedside.
The nurse is teaching a patient about rifampin. Which statement by the patient indicates understanding of the teaching?
- A. I should not wear soft contact lenses while taking rifampin
- B. I will need regular eye examinations while taking this drug
- C. I will report orange urine to my provider immediately
- D. I understand that renal toxicity is a common adverse effect
Correct Answer: A
Rationale: Rifampin stains fluids red-orange, risking soft lens damage; eye exams are for ethambutol, and urine color is benign. Patients taking rifampin should be warned that urine, feces, saliva, sputum, sweat, and tears may turn a harmless red-orange color.
In choosing a benzodiazepam to treat anxiety the prescriber needs to be aware of the possibility of dependence. The benzodiazepam with the greatest likelihood of rapidly developing dependence is:
- A. Chlordiazepoxide (Librium)
- B. Clonazepam (Klonopin)
- C. Alprazolam (Xanax)
- D. Oxazepam (Serax)
Correct Answer: C
Rationale: Alprazolam's short half-life increases dependence risk.
A patient has come to the clinic and been diagnosed with Lyme disease. The physician has ordered oral tetracycline. What is important for the nurse to include in the teaching plan about tetracycline? (Select all that apply.)
- A. Do not take the drug with anything high in sodium content to keep from producing a state of hypernatremia in the body.
- B. Do not take the drug with foods or other drugs that contain calcium.
- C. Avoid eating bananas at the same time you take this drug as the potassium content of the tetracycline can produce hyperkalemia in the body.
- D. Avoid exposure to the sun when taking this drug as it can turn your skin purple.
Correct Answer: B
Rationale: The antibiotic tetracycline is not absorbed from the gastrointestinal (GI) tract if calcium or calcium products (e.g., milk) are present in the stomach. It cannot be taken with iron products because a chemical reaction occurs preventing absorption. Although tetracycline can increase sun sensitivity, it does not turn the skin purple. Patients who take tetracycline do not need to avoid eating bananas or foods that are high in potassium.
The nurse is preparing to administer a medication from a multidose bottle. The label is torn and soiled but the name of the medication is still readable. What is the nurses priority action?
- A. Discard the entire bottle and contents and obtain a new bottle.
- B. Find the drug information and create a new label for the bottle.
- C. Ask another nurse to verify the contents of the bottle.
- D. Administer the medication if the name of the drug can be clearly read.
Correct Answer: A
Rationale: When the drug label is soiled obscuring some information the safest action by the nurse is to discard the bottle and contents because drug labels contain a great deal of important information, far more than just the name of the drug. Concentration of the drug, expiration date, administration directions, and precautions may be missing from the label and so put the patient at risk. Looking up drug information in a drug handbook or consulting with another nurse will not supply the expiration date or concentration of medication. Be safe and discard the bottle and its contents.