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After teaching a group of nursing students about nonprescription drugs, the nursing instructor determines that the teaching was successful when the students identify which of the following?
- A. They require a licensed health care provider's signature.
- B. They are referred to as over-the-counter drugs.
- C. They can be taken without risk to the client.
- D. They do not have certain labeling requirements.
Correct Answer: B
Rationale: Nonprescription drugs are often referred to as over-the-counter (OTC) drugs. They do not require a prescription (a licensed health care provider's signature) but do not come without risk to the client. The federal government has imposed labeling requirements of OTC drugs and they should only be taken as directed on the label unless under the supervision of a health care provider.
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A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium level is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client?
- A. Calcium chloride
- B. Calcium gluconate
- C. Calcitonin (Miacalcin)
- D. Large doses of vitamin D
Correct Answer: C
Rationale: The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia. Calcium gluconate and calcium chloride are medications used for the treatment of tetany, which occurs as a result of acute hypocalcemia. In hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid hormone, decreases the plasma calcium level by inhibiting bone resorption and lowering the serum calcium concentration.
When completing the check to ensure that the right drug is being administered to the client, which of the following should the nurse compare?
- A. Medication
- B. Container label
- C. Medication record
- D. All the above
Correct Answer: D
Rationale: The nurse compares the medication, container label, and medication record and then the MAR as the item is removed from the cart and before the actual administration of the drug.
A nurse is teaching a client who has a new prescription for Ramelteon. The nurse should instruct the client to avoid which of the following foods while taking this medication?
- A. Baked potato
- B. Fried chicken
- C. Whole-grain bread
- D. Citrus fruits
Correct Answer: B
Rationale: High-fat foods like fried chicken can delay ramelteon's onset, a melatonin receptor agonist.
A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus previously had been well controlled with glyburide (DiaBeta) daily, but recently the fasting blood glucose level has been 180 to 200 mg/dL. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?
- A. Prednisone
- B. Phenelzine (Nardil)
- C. Atenolol (Tenormin)
- D. Allopurinol (Zyloprim)
Correct Answer: A
Rationale: Prednisone may decrease the effect of oral hypoglycemics, insulin, diuretics, and potassium supplements. Option 2, a monoamine oxidase inhibitor, and option 3, a β-blocker, have their own intrinsic hypoglycemic activity. Option 4 decreases urinary excretion of sulfonylurea agents, causing increased levels of the oral agents, which can lead to hypoglycemia.
Anaphylactic shock is a:
- A. Type I reaction, called immediate hypersensitivity reaction
- B. Type II reaction, called cytotoxic hypersensitivity reaction
- C. Type III allergic reaction, called immune complex hypersensitivity
- D. Type IV allergic reaction, called delayed hypersensitivity reaction
Correct Answer: A
Rationale: Anaphylactic shock is a Type I immediate hypersensitivity reaction , IgE-mediated, unlike cytotoxic (II), immune complex (III), or delayed (IV).