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A provider may consider testing for CYP2D6 variants prior to starting tamoxifen for breast cancer to:
- A. Ensure the patient will not have increased adverse effects from the tamoxifen
- B. Identify if the patient is a poor metabolizer, potentially reducing conversion to active metabolites
- C. Evaluate risk of drug interactions with tamoxifen
- D. Determine if the patient requires a higher dose due to ultra-rapid metabolism
Correct Answer: B
Rationale: CYP2D6 testing identifies poor metabolizers who may not convert tamoxifen to its active form (endoxifen), impacting efficacy, not just ADRs or interactions .
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A 73-year-old male patient is being discharged home today. The discharge order reads: Take 10 mL of guaifenesin (Robitussin) with plastic measuring caps. How much should the nurse teach the client to take at home?
- A. 1/2 tsp
- B. 1 tsp
- C. 2 tsp
- D. 1 tbsp
Correct Answer: C
Rationale: 10 mL equals 2 teaspoons (1 tsp = 5 mL), the correct household measure for patient teaching.
Henry presents to clinic with a significantly swollen, painful great toe and is diagnosed with gout. Of the following, which would be the best treatment for Henry?
- A. High-dose colchicine
- B. Low-dose colchicine
- C. High-dose aspirin
- D. Acetaminophen with codeine
Correct Answer: B
Rationale: Low-dose colchicine effectively treats acute gout with fewer side effects than high-dose ; aspirin worsens gout.
Which of the following best describes the effect of propylthiouracil on thyroid hormone production?
- A. It blocks the release of thyrotropin-releasing hormone
- B. It inhibits uptake of iodide by thyroid cells
- C. It prevents the release of thyroid hormone from thyroglobulin
- D. It blocks iodination and coupling of tyrosines in thyroglobulin to form thyroid hormones
Correct Answer: D
Rationale: Propylthiouracil blocks iodination and coupling in thyroglobulin, inhibiting thyroid hormone synthesis.
The nursing instructor is discussing drug therapy in the older adult. What would the instructor tell the students about what could affect therapeutic dosing in an older adult?
- A. Changes in the gastrointestinal (GI) system can reduce drug absorption.
- B. In older adults, drugs enter into circulation more quickly.
- C. In older adults, drugs are distributed to a smaller portion of the tissues.
- D. In older adults, drugs have an increased action
Correct Answer: A
Rationale: GI changes in aging (e.g., reduced motility) decrease absorption, affecting dosing.
A nurse is teaching a patient about a new prescription for hydrochlorothiazide. Which statement indicates that the patient understands the teaching?
- A. I should increase my potassium intake.
- B. I may experience swelling in my legs.
- C. I need to monitor my blood sugar levels.
- D. I can take this medication any time of the day.
Correct Answer: A
Rationale: Hydrochlorothiazide can cause hypokalemia; increasing potassium intake shows understanding, unlike swelling (opposite effect) or timing flexibility (best in morning).