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A staff educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages?
- A. Increased renal secretion
- B. Increased medication-metabolizing enzymes
- C. Liver failure
- D. Peripheral vascular disease
Correct Answer: C
Rationale: Liver failure impairs metabolism, and concurrent use of medications metabolized by the same pathway can increase drug levels, both necessitating lower doses.
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Which of the following produced by the pancreatic beta cells:
- A. Insulin
- B. Gastrin
- C. Somatostatin
- D. Glucagon
Correct Answer: A
Rationale: Insulin is secreted by pancreatic beta cells to lower blood glucose.
Following drugs have disulfiram-like reaction when taken with alcohol EXCEPT
- A. Sulfonylureas
- B. Amoxicillin
- C. Metronidazole
- D. Cefoperazone
Correct Answer: B
Rationale: Metronidazole, cefoperazone, and some sulfonylureas cause a disulfiram-like reaction (flushing, nausea) with alcohol by inhibiting aldehyde dehydrogenase; amoxicillin does not.
The U.S. Food and Drug Administration approval is required for:
- A. Medical devices, including artificial joints
- B. Over-the-counter vitamins
- C. Herbal products, such as St John's wort
- D. Dietary supplements, such as Ensure
Correct Answer: A
Rationale: FDA approval is required for medical devices like artificial joints , but not OTC vitamins, herbal products, or supplements (B-D), which have lighter oversight.
A physician order is written for a patient to receive 500 mL of normal saline IV over 8 hours. If the IV infusion set delivers 15 drops/mL, how many drops per minute should the patient receive?
- A. 15 drops/min
- B. 20 drops/min
- C. 32 drops/min
- D. 64 drops/min
Correct Answer: A
Rationale: If a patient were to receive 500 mL in 8 hours, dividing 500 by 8 would mean that the patient would receive 62.5 mL in 1 hour, or 60 minutes. Setting up the equation, 15 drops/mL/X = 62.5 mL/60 minutes, and cross-multiplying, the answer will be 15 drops/min.
A nurse is caring for a client who is receiving an intravenous (IV) infusion of an antineoplastic medication. During the infusion, the client complains of pain at the insertion site. During an inspection of the site, the nurse notes redness and swelling and that the rate of infusion of the medication has slowed. The nurse should take which appropriate action?
- A. Notify the registered nurse.
- B. Administer pain medication to reduce the discomfort.
- C. Apply ice and maintain the infusion rate, as prescribed.
- D. Elevate the extremity of the IV site, and slow the infusion.
Correct Answer: A
Rationale: When antineoplastic medications (Chemotherapeutic Agents) are administered via IV, great care must be taken to prevent the medication from escaping into the tissues surrounding the injection site, because pain, tissue damage, and necrosis can result. The nurse monitors for signs of extravasation, such as redness or swelling at the insertion site and a decreased infusion rate. If extravasation occurs, the registered nurse needs to be notified; he or she will then contact the health care provider.