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After teaching a group of students about the different routes of medication administration, the nursing instructor determines that the teaching was successful when the students identify which of the following as a topical drug?
- A. Capsule
- B. Suppository
- C. Nebulized bronchodilator
- D. Nicotine patch
Correct Answer: B
Rationale: Topical drugs are drugs that are applied to the outer layer of the skin but not absorbed through the skin, such as eyedrops and suppositories. A nebulized bronchodilator is an inhaled medication. A nicotine patch delivers the medication transdermally; that is, it is readily absorbed from the skin. A capsule is a form of oral medication.
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A patient has a drug level of 50 units/mL and the drug's half-life is 1 hour. If concentrations above 25 units/mL are considered toxic and no more drug is given, how long will it take for the blood level to reach the nontoxic range?
- A. 30 minutes
- B. 1 hour
- C. 2 hours
- D. 3 hours
Correct Answer: C
Rationale: Half-life is the time required for the serum concentration of a drug to decrease by 50%. After 1 hour, the serum concentration would be 25 units/mL (50/2). After 2 hours, the serum concentration would be 12.5 units/mL (25/2) and reach the nontoxic range.
Low doses of aspirin prolong bleeding time by selectively inhibiting synthesis of the following mediator in the platelets:
- A. Thromboxane Aâ‚‚
- B. 5-Hydroxytryptamine
- C. Platelet activating factor
- D. Prostacyclin
Correct Answer: A
Rationale: Low-dose aspirin irreversibly inhibits COX-1 in platelets, reducing thromboxane Aâ‚‚ production, which promotes platelet aggregation, thus prolonging bleeding time.
Jim presents with complaints of 'heartburn' that is minimally relieved with Tums (calcium carbonate) and is diagnosed with gastroesophageal reflux disease (GERD). An appropriate first-step therapy would be:
- A. Omeprazole (Prilosec) twice a day
- B. Ranitidine (Zantac) twice a day
- C. Famotidine (Pepcid) once a day
- D. Metoclopramide (Reglan) four times a day
Correct Answer: B
Rationale: Ranitidine , an H2 blocker, is a standard first-line GERD treatment; PPIs are next-step, and metoclopramide is for motility.
A nurse is preparing a teaching plan for a female client who has Bipolar disorder and a new prescription for Carbamazepine. Which of the following instructions should the nurse include in the teaching? (Select one that does not apply.)
- A. This medication can safely be taken during pregnancy.
- B. Eliminate grapefruit juice from your diet.
- C. You will need to have a complete blood count and carbamazepine levels drawn periodically.
- D. You'll your provider if you develop a rash.
Correct Answer: A
Rationale: Grapefruit juice interacts, blood counts monitor toxicity, rash signals reaction, and driving caution addresses sedation.
A 70-year-old patient has just received a drug that can cause sedation. What would be the priority nursing diagnosis for this patient?
- A. Noncompliance: Cost of the drug
- B. Deficient knowledge: Unfamiliar with drug therapy
- C. Risk for injury: Related to adverse effects of the drug
- D. Ineffective health maintenance: Need for medication
Correct Answer: C
Rationale: Sedation increases the risk of falls or injury, making 'Risk for injury' the priority diagnosis over knowledge deficits or compliance issues.