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A physician has ordered intramuscular (IM) injections of morphine, a narcotic, every 4 hours as needed for pain in a motor vehicle accident victim. The nurse is aware this drug has a high abuse potential. Under what category would morphine be classified?
- A. Schedule I
- B. Schedule II
- C. Schedule III
- D. Schedule IV
Correct Answer: B
Rationale: Narcotics with a high abuse potential are classified as Schedule II drugs because of severe dependence liability. Schedule I drugs have high abuse potential and no accepted medical use. Schedule III drugs have a lesser abuse potential than II and an accepted medical use. Schedule IV drugs have low abuse potential and limited dependence liability.
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Desmopressin acetate (DDAVP) is prescribed for the treatment of diabetes insipidus. The nurse monitors the client after medication administration for which therapeutic response?
- A. Decreased urinary output
- B. Decreased blood pressure
- C. Decreased peripheral edema
- D. Decreased blood glucose level
Correct Answer: A
Rationale: Desmopressin promotes renal conservation of water. The hormone carries out this action by acting on the collecting ducts of the kidney to increase their permeability to water, which results in increased water reabsorption. The therapeutic effect of this medication would be manifested by a decreased urine output. Options 2, 3, and 4 are unrelated to the effects of this medication.
Which of the following drugs is considered a first-generation cephalosporin?
- A. Cefepime
- B. Cefazolin
- C. Ceftriaxone
- D. Cephalexin
Correct Answer: B
Rationale: Cefazolin is a first-generation cephalosporin, effective against Gram-positive bacteria, unlike cefepime (fourth) or ceftriaxone (third).
A patient presents to the emergency department with a drug level of 50 units/mL. The half-life of this drug is 1 hour. With this drug, concentrations above 25 units/mL are considered toxic and no more drug is given. How long will it take for the blood level to reach the non-toxic range?
- A. 30 minutes
- B. 1 hour
- C. 2 hours
- D. 3 hours
Correct Answer: B
Rationale: Half-life is the time required for the serum concentration of a drug to decrease by 50%. After 1 hour, the serum concentration would be 25 units/mL (50/2) if the body can properly metabolize and excrete the drug. After 2 hours, the serum concentration would be 12.5 units/mL (25/2) and reach the nontoxic range. In 30 minutes the drug level would be 37.5 units/mL, whereas in 3 hours the drug level would be 6.25.
To reduce potential adverse effects, patients taking a peripherally acting alpha1 antagonist should do all of the following EXCEPT:
- A. Take the dose at bedtime
- B. Sit up slowly and dangle their feet before standing
- C. Monitor their blood pressure and skip a dose if the pressure is less than 120/80
- D. Weigh daily and report weight gain of greater than 2 pounds in one day
Correct Answer: C
Rationale: Skipping doses based on blood pressure is not recommended; it risks uncontrolled hypertension.
A nurse is providing instructions to a female client who has a new prescription for Zolpidem. Which of the following instructions should the nurse include?
- A. Notify the provider if you plan to become pregnant.
- B. Take the medication 1 hr before you plan to go to sleep.
- C. Allow at least 6 hr for sleep when taking zolpidem.
- D. To increase the effectiveness of zolpidem, take it with a bedtime snack.
Correct Answer: A
Rationale: Pregnancy notification is key due to zolpidem's risks; it's taken just before sleep, needing 7-8 hours.