Nokea
An elderly person has been prescribed lactulose for treatment of chronic constipation. Monitoring with long-term treatment would include:
- A. Electrolytes, including potassium and chloride
- B. Bone mineral density for osteoporosis
- C. Magnesium level
- D. Liver function
Correct Answer: A
Rationale: Lactulose can alter electrolytes (e.g., potassium) in the elderly; osteoporosis or magnesium aren't directly linked.
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The reason that two MMR vaccines at least a month apart are recommended is:
- A. The second dose of MMR 'boosts' the immunity built from the first dose
- B. Two vaccines 1 month apart is the standard dosing for all live virus vaccines
- C. If the two MMR vaccine doses are given too close together there is a greater likelihood of severe localized reaction to the vaccine
- D. Only 95% of patients are fully immunized for measles after the first vaccine, with 99% having immunity after two doses of MMR
Correct Answer: D
Rationale: Two MMR doses ensure 99% immunity, as 95% respond to one dose; boosting is secondary to this goal.
Which lab test(s) would be used to assess liver and/or renal function before administering medications? (Select one that does not apply.)
- A. CBC
- B. LDH
- C. ALT
- D. Crs
Correct Answer: A
Rationale: Liver function tests include LDH (lactic dehydrogenase) and ALT (alanine aminotransferase). Renal function tests include Crs (serum creatinine) and BUN (blood urea nitrogen). Although a CBC (complete blood count) and an aPTT are useful in assessing the patient before administration of medication, they are not renal or hepatic function tests.
Being competent in the use of information technology in clinical practice is expected in professional nurses. Advanced practice competence includes the ability to:
- A. Search for information using the most common search engines
- B. Serve as content experts in developing, implementing, and evaluating information systems
- C. Write programs to assure the integrity of health information
- D. Use information technology to prescribe drugs
Correct Answer: B
Rationale: Advanced practice nurses contribute expertise in IT system development and evaluation.
The student nurse asks the instructor why a patient with a central nervous system infection is receiving antibiotics that will not cross the blood-brain barrier. What is the instructor's most correct response?
- A. A severe infection alters the blood-brain barrier to allow the drug to cross.
- B. A medication that is water soluble is more likely to cross the blood-brain barrier.
- C. Antibiotics are the exception to the blood-brain barrier and cross easily.
- D. An infection that spreads outside the central nervous system helps drugs cross the barrier.
Correct Answer: A
Rationale: Effective antibiotic treatment can occur only when the infection is severe enough to alter the blood-brain barrier and allow antibiotics to cross. Lipid-soluble, not water-soluble, medications cross the blood-brain barrier more easily and most antibiotics are lipid soluble, so they are not the exception. No matter where the infection originates, drugs must cross the blood-brain barrier to treat central nervous system infections.
A nurse is preparing to perform a follow-up assessment on a client who takes Chlorpromazine for the treatment of Schizophrenia. The nurse should expect to find the greatest improvement in which of the following manifestations?(Select one that does not apply.)
- A. Disorganized speech
- B. Bizarre behavior
- C. Impaired social interactions
- D. Hallucinations
Correct Answer: C
Rationale: Chlorpromazine improves positive symptoms like speech , behavior , and hallucinations , less so negative symptoms.