Nokea
After a few weeks on a drug, a patient reports profound thirst and the production of large volumes of dilute urine (polyuria). Which of the following drugs is most likely responsible for the symptoms?
- A. Diazepam
- B. Fluoxetine
- C. Haloperidol
- D. Lithium
Correct Answer: D
Rationale: Lithium causes nephrogenic diabetes insipidus, leading to thirst and polyuria.
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Which legislation authorizes the FDA to determine the safety of a drug before its marketing?
- A. Federal Food, Drug, and Cosmetic Act (1938)
- B. Durham Humphrey Amendment (1952)
- C. Controlled Substances Act (1970)
- D. Kefauver Harris Drug Amendment (1962)
Correct Answer: A
Rationale: The Federal Food, Drug, and Cosmetic Act of 1938 authorized the FDA to determine the safety of all drugs before marketing. Later amendments and acts helped tighten FDA control and ensure drug safety.
The nurse receives an order to administer an unfamiliar medication and obtains a nurse's drug guide published four years earlier. What is the nurse's most prudent action?
- A. Find a more recent reference source.
- B. Use the guide if the drug is listed.
- C. Ask another nurse for drug information.
- D. Verify the information in the guide with the pharmacist.
Correct Answer: A
Rationale: The nurse is responsible for all medications administered and must find a recent reference source to ensure the information learned about the medication is correct and current. Using an older drug guide could be dangerous because it would not contain the most up-to-date information. Asking another nurse or the pharmacist does not guarantee accurate information will be obtained and could harm the patient if the information is wrong.
The client with small cell lung cancer is being treated with etoposide (VePesid). The nurse who is assisting in caring for the client during its administration understands that which side effect is specifically associated with this medication?
- A. Alopecia
- B. Chest pain
- C. Pulmonary fibrosis
- D. Orthostatic hypotension
Correct Answer: D
Rationale: A side effect specific to etoposide is orthostatic hypotension. The client's blood pressure is monitored during the infusion. Hair loss occurs with nearly all the antineoplastic medications. Chest pain and pulmonary fibrosis are unrelated to this medication.
Information technology (IT) can also be used to interact with a patient between encounters. Which of the following statements about such interactions is true?
- A. Patients feel the provider does not care about them if they are not seen in a face-to-face encounter.
- B. Data collected from patients between encounters via IT is less accurate and complete.
- C. Collecting data between encounters via IT may mean a more efficient face-to-face encounter.
- D. Between encounters is a good time to collect screening data.
Correct Answer: C
Rationale: IT-collected data between encounters can streamline subsequent in-person visits.
When taking a medication history on a patient why should the nurse ask about the use of alternative therapies?
- A. Patients who use new drugs are usually not compliant with medical regimens.
- B. Many drug-alternative therapy interactions can cause serious problems and should be avoided.
- C. Natural products may be more effective and the drug may not be needed.
- D. The cost of the drug and the alternative therapy may be too great for the patient to handle.
Correct Answer: B
Rationale: Alternative therapies can interact with prescribed drugs, potentially causing adverse effects, making this a critical assessment point.