Nokea
Chemotherapeutic agents often produce a degree of myelosuppression including leukopenia. Leukopenia does not present immediately but is delayed several days or weeks because:
- A. the client's hemoglobin and hematocrit are normal.
- B. red blood cells are affected first.
- C. folic acid levels are normal.
- D. the current white cell count is not affected by chemotherapy.
Correct Answer: D
Rationale: Time is required to clear circulating cells before the effect that chemotherapeutic drugs have on precursor cell maturation in the bone marrow becomes evident.
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A 55 year-old female asks a nurse the following, 'Which mineral/vitamin is the most important to prevent progression of osteoporosis.' The nurse should state:
- A. Potassium
- B. Magnesium
- C. Calcium
- D. Vitamin B12
Correct Answer: C
Rationale: Calcium is the most recognized osteoporosis treatment.
A diet high in fiber content can help an individual to:
- A. lose body weight fast.
- B. reduce diabetic ketoacidosis.
- C. lower cholesterol.
- D. reduce the need for folate.
Correct Answer: C
Rationale: Fiber-rich foods (such as grains, apples, potatoes, and beans) can help lower cholesterol.
A client is given an opiate drug for pain relief following general anesthesia. The client becomes extremely somnolent with respiratory depression. The physician is likely to order the administration of:
- A. naloxone (Narcan)
- B. labetalol (Normodyne)
- C. neostigmine (Prostigmin)
- D. thiothixene (Navane)
Correct Answer: A
Rationale: Naloxone reverses opioid-induced respiratory depression and somnolence by antagonizing opioid receptors. The other drugs do not address opioid overdose.
Some drugs are excreted into bile and delivered to the intestines. Prior to elimination from the body, the drug might be absorbed. This process is known as:
- A. hepatic clearance.
- B. total clearance.
- C. enterohepatic cycling.
- D. first-pass effect.
Correct Answer: C
Rationale: Drugs and drug metabolites with molecular weights higher than 300 can be excreted via the bile, stored in the gallbladder, delivered to the intestines by the bile duct, and then reabsorbed into the circulation. This process reduces the elimination of drugs and prolongs their half-life and duration of action in the body. Hepatic clearance is the amount of drug eliminated by the liver. Total clearance is the sum of all types of clearance including renal, hepatic, and respiratory. First-pass effect is the amount of drug absorbed from the GI tract, then metabolized by the liver (reducing the amount of drug that makes it into circulation).
A patient is currently having a petit mal seizure in the clinic on the floor. Which of the following criteria has the highest priority in this situation?
- A. Provide a safe environment free of obstructions in the immediate area
- B. Call a code
- C. Contact the patient's physician
- D. Prevent excessive movement of the extremities
Correct Answer: A
Rationale: Patient safety should be the top concern about this patient.