Nokea
Cecil and his wife are traveling to Southeast Asia on vacation and he has come into the clinic to review his medications. He is healthy with only mild hypertension that is well controlled. He asks about getting 'a shot' to prevent blood clots like his friend Ralph did before international travel. The correct response would be:
- A. Administer one dose of low-molecular weight heparin 24 hours before travel
- B. Prescribe one dose of warfarin to be taken the day of travel
- C. Consult with a hematologist regarding a treatment plan for Cecil
- D. Explain that Cecil is not at high risk of a blood clot and provide education about how to prevent blood clots while traveling
Correct Answer: D
Rationale: Cecil's low risk doesn't warrant prophylaxis; education on hydration and movement suffices. Heparin or warfarin is overkill without indication.
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A nurse is teaching a client who has a new prescription for Diphenhydramine for allergic Rhinitis. The nurse should instruct the client to monitor for which of the following adverse reactions of this medication? (Select one that does not apply.)
- A. Dry mouth
- B. Nonproductive cough
- C. Urinary Hesitation
- D. Drowsiness
Correct Answer: B
Rationale: Diphenhydramine causes dry mouth , drowsiness , and urinary hesitation due to anticholinergic effects.
Which of the following is corresponding to the following statement: this drug is used for diabetes mellitus and while using there is an increased risk of pancreatitis:
- A. Miglitol
- B. Pioglitazon
- C. Exenatide
- D. Glimepiride
Correct Answer: C
Rationale: Exenatide, a GLP-1 agonist, treats diabetes and has a known risk of pancreatitis as a rare but serious side effect.
While administering a medication that the nurse has researched and found to have limited effectiveness, the patient tells the nurse, I have read all about this drug and it is such a wonder drug. I'm so lucky my doctor prescribed it because I just know it will treat my problem. The nurse suspects this drug will be more effective than usual for this patient because of what effect?
- A. Cumulative effect
- B. First-pass effect
- C. Placebo effect
- D. Cross-tolerance effect
Correct Answer: C
Rationale: A drug is more likely to be effective if the patient thinks it will work than if the patient believes it will not work. This is called the placebo effect. If a drug is taken in successive doses at intervals that are shorter than recommended, or if the body is unable to eliminate a drug properly, the drug can accumulate in the body, leading to toxic levels and adverse effects. This is a cumulative effect. First-pass effect addresses the reduction of available drug when taken orally due to metabolism in the liver before the drug reaches the bloodstream. Cross-tolerance is resistance to drugs within the same class.
Tom is taking lithium for bipolar disorder. He should be taught to:
- A. Take his lithium with food
- B. Eat a diet with consistent levels of salt (sodium)
- C. Drink at least 2 quarts of water if he is in a hot environment
- D. Monitor blood glucose levels
Correct Answer: B
Rationale: Consistent sodium intake prevents fluctuations in lithium levels.
There is enough preliminary evidence to recommend that children with autism receive which supplemental nutrient?
- A. Vitamin B1 (thiamine)
- B. Vitamin B2 (riboflavin)
- C. Calcium
- D. Omega-3 fatty acids
Correct Answer: D
Rationale: Preliminary evidence suggests omega-3 fatty acids may benefit children with autism.