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A primary health care provider instructs a nurse to administer a medication to a patient STAT. Which action by the nurse would be most appropriate?
- A. Insist on obtaining a written report before administering any drug.
- B. Administer the drug as ordered by the physician.
- C. Forgo obtaining the physician's order after the drug has been administered.
- D. Document the administration of the drug only after receiving the physician's order.
Correct Answer: B
Rationale: The nurse should administer the drug as instructed without a written order as it is an emergency. The nurse should, however, ensure that the physician's order is obtained after the drug has been administered. Waiting for a written order during an emergency may exacerbate the patient's condition. The nurse should complete the documentation immediately after the administration of the drug and not wait until the physician's order is received.
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Janie presents to the clinic with hard ear wax in both ear canals. Instructions regarding home removal of hard cerumen include:
- A. Moisten a cotton swab (Q-tip) and swab the ear canal twice daily
- B. Instill tap water in both ears while bathing
- C. Squirt hydrogen peroxide into ears with each bath
- D. Instill carbamide peroxide (Debrox) twice daily until canals are clear
Correct Answer: D
Rationale: Carbamide peroxide softens cerumen safely; Q-tips risk impaction, and water or peroxide are less effective.
A patient taking an oral diuretic for about six (6) months presents with elevated fasting and post prandial blood glucose levels. You suspect the glycemic problems are diuretic induced. What is the most likely cause?
- A. Acetazolamide
- B. Amiloride
- C. Chlorothiazide
- D. Spironolactone
Correct Answer: C
Rationale: Thiazides like chlorothiazide impair glucose tolerance by reducing insulin sensitivity.
A nurse is administering digoxin to a patient. To administer medications so that the drug is as effective as possible, the nurse needs to consider what?
- A. Pharmacotherapeutics
- B. Pharmacokinetics
- C. Pharmacoeconomics
- D. Pharmacogenomics
Correct Answer: B
Rationale: When administering a drug, the nurse needs to consider the phases of pharmacokinetics so that the drug regimen can be made as effective as possible. Pharmacogenomics is the area of study that includes mapping of the human genome. Pharmacotherapeutics is the branch of pharmacology that deals with the uses of drugs to treat, prevent, and diagnose disease. Pharmacoeconomics includes all costs involved in drug therapy.
Ray has been diagnosed with hypertension and an angiotensin-converting enzyme inhibitor is determined to be needed. Prior to prescribing this drug, the NP should assess for:
- A. Hypokalemia
- B. Impotence
- C. Decreased renal function
- D. Inability to concentrate
Correct Answer: C
Rationale: ACE inhibitors can worsen renal function, necessitating baseline assessment.
Which is the most authoritative reference for medications that are injected?
- A. Martindale: The Complete
- B. Handbook on Injectable Drugs
- C. DailyMed
- D. Handbook of Nonprescription Drugs
Correct Answer: B
Rationale: The Handbook on Injectable Drugs is the most comprehensive reference available on the topic of compatibility of injectable drugs.