Nokea
Cynthia is taking valproate (Depakote) for seizures and would like to get pregnant. What advice would you give her?
- A. Valproate is safe during all trimesters of pregnancy.
- B. She can get pregnant while taking valproate, but she should take adequate folic acid.
- C. Valproate is not safe at any time during pregnancy.
- D. Valproate is a known teratogen, but may be taken after the first trimester if necessary.
Correct Answer: D
Rationale: Valproate is teratogenic (e.g., neural tube defects) but may be used post-first trimester if essential.
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The nurse administers an intravenous medication with a half-life of 24 hours but recognizes what factors in this patient could extend the drug's half-life? (Select one that does not apply.)
- A. Gastrointestinal disease
- B. Kidney disease
- C. Liver disease
- D. Cardiovascular disease
Correct Answer: A
Rationale: Kidney disease could slow excretion and extend the drug's half-life. Liver disease could slow metabolism resulting in an extended half-life. Cardiovascular disease could slow distribution resulting in a longer half-life. Gastrointestinal disease would not impact half-life because the medication was injected directly into the bloodstream. Route of administration would not extend half-life because IV injection eliminates the absorption step in the process.
A nurse is caring for a client who is receiving an intravenous (IV) infusion of an antineoplastic medication. During the infusion, the client complains of pain at the insertion site. During an inspection of the site, the nurse notes redness and swelling and that the rate of infusion of the medication has slowed. The nurse should take which appropriate action?
- A. Notify the registered nurse.
- B. Administer pain medication to reduce the discomfort.
- C. Apply ice and maintain the infusion rate, as prescribed.
- D. Elevate the extremity of the IV site, and slow the infusion.
Correct Answer: A
Rationale: When antineoplastic medications (Chemotherapeutic Agents) are administered via IV, great care must be taken to prevent the medication from escaping into the tissues surrounding the injection site, because pain, tissue damage, and necrosis can result. The nurse monitors for signs of extravasation, such as redness or swelling at the insertion site and a decreased infusion rate. If extravasation occurs, the registered nurse needs to be notified; he or she will then contact the health care provider.
Azathioprine is useful in the following diseases EXCEPT:
- A. Rheumatoid arthritis
- B. Psoriatic arthritis
- C. Reactive arthritis
- D. osteoarthritis
Correct Answer: D
Rationale: Azathioprine is not typically used for osteoarthritis, a degenerative condition.
A nurse working in an emergency department is caring for a client who has Benzodiazepine toxicity due to an overdose. Which of the following actions is the nurse's priority?
- A. Administer flumazenil.
- B. Identify the client's level of orientation.
- C. Infuse IV fluids.
- D. Prepare the client for gastric lavage
Correct Answer: B
Rationale: Assessing orientation is the priority to determine the severity of toxicity and guide interventions.
A nurse in an acute mental health facility is caring for a client who is experiencing withdrawal from Opioid use and has a new prescription for Clonidine. Which of the following actions should the nurse identify as the priority?
- A. Administer the clonidine on the prescribed schedule.
- B. Provide ice chips at the client's bedside.
- C. Educate the client on the effects of clonidine.
- D. Obtain baseline vital signs
Correct Answer: D
Rationale: Baseline vital signs are the priority to assess withdrawal severity and monitor clonidine's effects.