Nokea
All nonsteroidal anti-inflammatory drugs (NSAIDS) have an FDA Black Box Warning regarding:
- A. Potential for causing life-threatening GI bleeds
- B. Increased risk of developing systemic arthritis with prolonged use
- C. Risk of life-threatening rashes, including Stevens-Johnson
- D. Potential for transient changes in serum glucose
Correct Answer: A
Rationale: NSAIDs carry a Black Box Warning for GI bleeding risk; rashes or glucose aren't highlighted.
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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 has been administering a drug to a patient intramuscularly (IM). The physician discontinued the IM dose and wrote an order for the drug to be given orally. The nurse notices that the oral dosage is considerably higher than the parenteral dose and understands that this is due to:
- A. Passive diffusion
- B. Active transport
- C. Glomerular filtration
- D. First-pass effect
Correct Answer: D
Rationale: The first-pass effect involves drugs that are absorbed from the small intestine directly into the portal venous system, which delivers the drug molecules to the liver. Once in the liver, enzymes break the drug into metabolites, which may become active or may be deactivated and readily excreted from the body. A large percentage of the oral dose is usually destroyed and never reaches tissues. Oral dosages account for the phenomenon to ensure an appropriate amount of the drug in the body to produce a therapeutic action. Passive diffusion is the major process through which drugs are absorbed into the body. Active transport is a process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney. Glomerular filtration is the passage of water and water-soluble components from the plasma into the renal tubule.
Drug of choice in phenothiazine induced parkinsonism is
- A. Levodopa
- B. Haloperidol
- C. Metoclopramide
- D. None of the above
Correct Answer: A
Rationale: Levodopa counters phenothiazine-induced parkinsonism.
Methylnaltrexone is used to treat constipation in:
- A. Patients with functional constipation
- B. Patients with irritable bowel syndrome-associated constipation
- C. Children with encopresis
- D. Opioid-associated constipation
Correct Answer: D
Rationale: Methylnaltrexone specifically reverses opioid-induced constipation; it's not for functional , IBS , or pediatric use.