Nokea
As an antacid, sodium bicarbonate has the following disadvantages EXCEPT:
- A. It causes acid rebound
- B. In ulcer patients, it increases risk of perforation
- C. It has low acid neutralizing capacity
- D. It is contraindicated in CHF
Correct Answer: C
Rationale: Sodium bicarbonate has high acid-neutralizing capacity, but it causes acid rebound, risks perforation in ulcers due to gas production, and is contraindicated in CHF due to sodium load.
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Under new U.S. Food and Drug Administration labeling, Pregnancy Categories will be:
- A. Strengthened with a new coding such as C+ or C- to discern when a drug is more or less toxic to the fetus
- B. Changed to incorporate a pregnancy risk summary and clinical considerations on the drug label
- C. Eliminated, and replaced with a link to the National Library of Medicine TOXNET Web site for in-depth information regarding pregnancy concerns
- D. Clarified to include information such as safe dosages in each trimester of pregnancy
Correct Answer: B
Rationale: FDA replaced categories with risk summaries and clinical considerations for clearer, narrative-based guidance, effective 2015.
A 35-year-old woman has Graves' disease, a small goiter, and symptoms that are deemed 'mild-to-moderate.' Propylthiouracil is prescribed. Which of the following is the most serious adverse response to this drug, for which close monitoring is required?
- A. Agranulocytosis
- B. Cholestatic jaundice
- C. Gout
- D. Renal tubular necrosis
Correct Answer: A
Rationale: Agranulocytosis is a severe, potentially fatal side effect of propylthiouracil requiring close monitoring due to its impact on white blood cell production.
A nurse is providing teaching to a client who has a new prescription for Clonidine to assist with maintenance of abstinence from opioids. The nurse should instruct the client to monitor for which of the following adverse effects?
- A. Diarrhea
- B. Dry mouth
- C. Insomnia
- D. Hypertension
Correct Answer: B
Rationale: Clonidine commonly causes dry mouth due to its anticholinergic effects.
A nurse is caring for a patient who is supposed to receive two drugs at the same time. What is the nurses priority action?
- A. Wash her hands before handling the medications.
- B. Consult a drug guide for compatibility.
- C. Question the patient concerning drug allergies.
- D. Identify the patient by checking the armband and asking the patient to state his name.
Correct Answer: B
Rationale: A nurse should first consult a drug guide for compatibility when two or more drugs are being given at the same time. After compatibility is determined the medication can be administered. The nurse will perform hand hygiene, check for patient allergies, and ensure the right patient receives the medication by using two identifiers.
Sarah, a 42-year-old female, requests a prescription for an anorexiant to treat her obesity. A trial of phentermine is prescribed. Prescribing precautions include:
- A. Understanding that obesity is a contraindication to prescribing phentermine
- B. Anorexiants may cause tolerance and should only be prescribed for 6 months
- C. Patients should be monitored for postural hypotension
- D. Renal function should be monitored closely while on anorexiants
Correct Answer: C
Rationale: Phentermine can cause postural hypotension, requiring monitoring.