Nokea
An older adult experiencing shortness of breath is brought to the hospital by her daughter. While obtaining the medication history from the patient and her daughter, the nurse discovers that neither has a list of the patient's current medications or prescriptions. The patient has a weekly pill dispenser that contains four different pills. The prescriptions are filled through the local pharmacy. Which resource would be appropriate to use in determining the medication names and doses?
- A. Martindale-The Complete Drug Reference
- B. Drugs and Facts Comparisons
- C. Senior citizens' center
- D. Patient's home pharmacy
Correct Answer: D
Rationale: The patient's pharmacy maintains an accurate record of all current medications, making it the best resource for identifying the drugs and doses.
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The intangible costs of drug therapy include:
- A. Loss of wages while undergoing therapy
- B. Inconvenience, pain, and suffering incurred with therapy
- C. Cost of medical equipment in the laboratory used to monitor therapeutic drug levels
- D. Cost of prescription drug coverage, such as Medicare Part D
Correct Answer: B
Rationale: Intangible costs are non-monetary, such as pain and suffering.
What factor influences drug absorption?
- A. Kidney function
- B. Route of administration
- C. Liver function
- D. Cardiovascular function
Correct Answer: B
Rationale: Drug absorption is influenced by the route of administration. IV administration is the fastest method; drug absorption is slower when given orally. Kidney function impacts excretion, liver function impacts metabolism, and cardiovascular function impacts distribution.
A nurse is reviewing laboratory findings and notes that a client's plasma Lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse?
- A. Perform immediate gastric lavage.
- B. Prepare the client for hemodialysis.
- C. Administrative and additional oral dose of lithium.
- D. Request a stat repeat of the laboratory test
Correct Answer: B
Rationale: A level of 2.1 mEq/L indicates toxicity (normal 0.6-1.2 mEq/L); hemodialysis is used for severe cases.
The patient asks the nurse why generic drugs would be used and voices concerns that only the brand name product will be safe. What is the nurses best response?
- A. Generic drugs are often less expensive.
- B. Some quality control problems have been found with generic drugs.
- C. Most generic drugs are very safe and can be cost effective as well.
- D. Although initial cost is higher for a brand name it may cost less in the long run.
Correct Answer: C
Rationale: Most generic medications are completely safe and may be identical to the brand name drug except generic medications are often less expensive, but this does not address the patients concern about safety. Although some quality control issues have occurred in the past, this does not address the patients concerns regarding safety or explain why generic drugs are prescribed and used. Although some doctors believe initial cost is higher but will cost less over time, this response also does not address the patients concerns.
A 52-year-old overweight woman presents to the clinic for a diabetes management. She had not been doing well controlling her blood sugars with metformin. Her last hemoglobin A1c was 13.4%, despite her taking her medication every day. The physician decides to start her on a long-acting insulin that is injected only once a day for better glucose control. Also, he wants the insulin to have a minimal risk of hypoglycemia. What is the most likely medication given to this patient?
- A. Insulin aspart
- B. Insulin glargine
- C. Insulin lispro
- D. NPH insulin
Correct Answer: B
Rationale: Insulin glargine is a long-acting, peakless insulin administered once daily, with a lower risk of hypoglycemia compared to other insulins.