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An 83-year-old woman has been given a thiazide diuretic to treat heart failure. She and her caregiver should be told to watch for which problems?
- A. Constipation and anorexia
- B. Fatigue, leg cramps, and dehydration
- C. Daytime sedation and lethargy
- D. Edema, nausea, and blurred vision
Correct Answer: B
Rationale: Electrolyte imbalance, leg cramps, fatigue, and dehydration are common complications when thiazide diuretics are given to elderly patients. The other options do not describe typical complications associated with thiazide diuretics in the elderly.
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The nurse recognizes that an elderly patient may experience a reduction in the stomach's ability to produce hydrochloric acid. This change may result in which effect?
- A. Delayed gastric emptying
- B. Increased gastric acidity
- C. Decreased gastrointestinal motility
- D. Altered absorption of some drugs
Correct Answer: D
Rationale: Reduction in the stomach's ability to produce hydrochloric acid is an aging-related change that results in a decrease in gastric acidity and may alter the absorption of some drugs. It does not directly cause delayed gastric emptying, increased gastric acidity, or decreased gastrointestinal motility.
The nurse is administering drugs to neonates and will consider which factor may contribute the most to drug toxicity?
- A. The lungs are immature.
- B. The kidneys are small.
- C. The liver is not fully developed.
- D. Excretion of the drug occurs quickly.
Correct Answer: C
Rationale: A neonate's liver is not fully developed and cannot detoxify many drugs, contributing most to drug toxicity. Immature lungs and small kidneys play lesser roles, and excretion is slow, not fast, due to organ immaturity.
When discussing dosage calculation for pediatric patients with a clinical pharmacist, the nurse notes that which type of dosage calculation is used most commonly in pediatric calculations?
- A. West nomogram
- B. Clark rule
- C. Height-to-weight ratio
- D. Milligram per kilogram of body weight formula
Correct Answer: D
Rationale: The milligram per kilogram formula, based on body weight, is the most common method of calculating doses for pediatric patients. West nomogram and Clark rule are available but less commonly used, and height-to-weight ratio is not a standard method.
The nurse is assessing a newly admitted 83-year-old patient and determines that the patient is experiencing polypharmacy. Which statement most accurately illustrates polypharmacy?
- A. The patient is experiencing multiple illnesses.
- B. The patient uses one medication for an illness several times per day.
- C. The patient uses over-the-counter drugs for an illness.
- D. The patient uses multiple medications simultaneously.
Correct Answer: D
Rationale: Polypharmacy usually occurs when a patient has several illnesses and takes medications for each of them, possibly prescribed by different specialists who may be unaware of other treatments the patient is undergoing. It involves multiple medications, not just multiple illnesses, a single medication, or only over-the-counter drugs.
A 7-year-old child will be receiving amoxicillin (Amoxil) 50 mg/kg/day in two divided doses. The child weighs 55 pounds. The medication, once reconstituted, is available as an oral suspension of 125 mg/5 mL. Identify how many milliliters will the child receive per dose.
Correct Answer: 25 mL
Rationale: Convert pounds to kilograms: 55 pounds = 25 kg. 25 kg x 50 mg/kg/day = 1250 mg/day. To get the amount per dose, divide 1250 by 2, which equals 625 mg/dose. To calculate the milliliters: 125 mg/5 mL = 625 mg/x mL. (125 * x) = (5 * 625); 125x = 3125; x = 25 mL/dose.