Nokea
Cara is taking levetiracetam (Keppra) to treat seizures. Routine education for levetiracetam includes reminding her:
- A. To not abruptly discontinue levetiracetam due to risk for withdrawal seizures
- B. To wear sunscreen due to photosensitivity from levetiracetam
- C. To get an annual eye exam while on levetiracetam
- D. To report weight loss if it occurs
Correct Answer: A
Rationale: Abrupt discontinuation of levetiracetam risks withdrawal seizures.
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You are doing an admission assessment on a patient. During the medication history portion of the assessment what would be important to assess with herbal supplements?
- A. Research them for interactions with other medications
- B. Discontinue them if taking prescription medications
- C. Take them one hour before prescription medications
- D. Take them three hours after prescription medications
Correct Answer: A
Rationale: Researching herbal interactions ensures safe integration with prescribed drugs, preventing adverse effects.
What does the nurse understand must occur in order to produce withdrawal syndrome?
- A. Addiction
- B. Craving
- C. Drug tolerance
- D. Physical dependence
Correct Answer: D
Rationale: Physical dependence causes withdrawal when a drug stops; addiction or tolerance don't suffice. Patients who develop a physical dependence on a drug will experience withdrawal syndrome when the drug is stopped.
A nurse is caring for a client after thyroidectomy and notes that calcium gluconate is prescribed for the client. The nurse determines that this medication has been prescribed to:
- A. Treat thyroid storm.
- B. Prevent cardiac irritability.
- C. Treat hypocalcemic tetany.
- D. Stimulate the release of parathyroid hormone.
Correct Answer: C
Rationale: Hypocalcemia can develop after thyroidectomy if the parathyroid glands are accidentally removed or injured during surgery. Manifestations develop 1 to 7 days after surgery. If the client develops numbness and tingling around the mouth, fingertips, or toes or muscle spasms or twitching, the health care provider is notified immediately. Calcium gluconate should be kept at the bedside.
The choice of diuretic to use in treating hypertension is based on:
- A. Presence of diabetes with loop diuretics being used for these patients
- B. Level of kidney function with a thiazide diuretic being used for an estimated glomerular filtration rate higher than the mid-40 mL/min range
- C. Ethnicity with aldosterone antagonists best for African Americans and older adults
- D. Presence of hyperlipidemia with higher doses needed for patients with LDL above 130 mg/dL
Correct Answer: B
Rationale: Thiazides are effective with GFR >40-50 mL/min; loops are used for lower GFR.
The nurse explains the Drug Enforcement Agency's (DEA's) schedule of controlled substances to the nursing assistant who asks, Do you ever get a prescription for Schedule I medications? What is the nurse's best response?
- A. Schedule I medications have no medical use so they are not prescribed.
- B. Schedule I medications have the lowest risk for abuse and do not require a prescription.
- C. Schedule I medications are only prescribed in monitored units for patient safety.
- D. Schedule I medications are found in antitussives and antidiarrheals sold over the counter.
Correct Answer: A
Rationale: Schedule I medications have no medical use and are never prescribed. Schedule V medications have the lowest risk for abuse and are found mostly in antitussives and antidiarrheals but they are not sold over the counter.