Art is a 55-year-old smoker who has been diagnosed with angina and placed on nitrates. He complains of headaches after using his nitrate. An appropriate reply might be:
- A. This is a parasympathetic response to the vasodilating effects of the drug.
- B. Headaches are common side effects with these drugs. How severe are they?
- C. This is associated with your smoking. Let's work on having you stop smoking.
- D. This is not related to your medication. Are you under a lot of stress?
Correct Answer: B
Rationale: Headaches are a common nitrate side effect due to vasodilation.
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A nurse is calculating a child's medication dose by using Clark's Rule. Which of the following calculations represents the application of Clark's Rule?
- A. Infant's age in months/150 months the average adult dose
- B. Child's age in years/child's age in years +12 times the average adult dose
- C. Weight of child in pounds/150 pounds the average adult dose
- D. Surface area in square meters/1.73 the average adult dose
Correct Answer: C
Rationale: Clark's Rule uses the child's weight to calculate the dose and assumes the adult dose is based on a 150-pound person. Fried's Rule applies to a child younger than 1 year of age and assumes that an adult dose would be appropriate for a child who is 12.5 years (150 months) old. Young's Rule applies to children 1 to 12 years of age. Surface area calculation of a child's dose is determined with the use of a nomogram including the child's height and weight.
A 25-year-old woman comes to the clinic complaining of rapid heart rate and easy fatigability. Laboratory results reveal low hemoglobin levels and microcytic red blood cells. The most suitable therapy for her condition will be:
- A. Folic acid
- B. Epoiten alfa
- C. Ferrous sulfate
- D. Vitamin B12
Correct Answer: C
Rationale: Microcytic anemia suggests iron deficiency; ferrous sulfate is the standard treatment.
A patient will begin taking streptomycin as part of the medication regimen to treat tuberculosis. Before administering this medication, the nurse will review which laboratory values in the patient's medical record?
- A. Complete blood count (CBC) with differential white cell count
- B. Blood urea nitrogen (BUN) and creatinine
- C. Potassium and magnesium levels
- D. Serum fasting glucose
Correct Answer: B
Rationale: Streptomycin risks nephrotoxicity, requiring renal function (BUN, creatinine) checks; CBC or electrolytes are less critical. Streptomycin can cause significant renal toxicity.
The average starting dose of warfarin is 5 mg daily. Higher doses of 7.5 mg daily should be considered in which patients?
- A. Pregnant women
- B. Elderly men
- C. Overweight or obese patients
- D. Patients with multiple comorbidities
Correct Answer: C
Rationale: Overweight/obese patients may need higher warfarin doses due to larger volume of distribution; pregnancy contraindicates warfarin.
During what phase of the nursing process would the nurse be required to consider the efficacy of nursing interventions related to drug therapy?
- A. Assessment
- B. Nursing diagnosis
- C. Interventions
- D. Evaluation
Correct Answer: D
Rationale: Evaluation assesses the effectiveness of interventions, including drug therapy outcomes, to determine if goals are met.