Nokea
Differences between brand-name drugs and their generic equivalents include:
- A. Active ingredient
- B. Cost
- C. Color of the tablet
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because generics have the same active ingredient as brand-name drugs but typically cost less, per FDA bioequivalence rules. Choice A is incorrect as active ingredients are identical. Choice C is wrong because color may differ but isn't a functional difference. Choice D is incorrect since only cost is a consistent distinction.
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What should be the nurse's priority action when a client diagnosed with angina pectoris complains of chest pain while taking a brisk walk?
- A. Administer nitroglycerin
- B. Have the client sit down
- C. Obtain an electrocardiogram
- D. Apply oxygen
Correct Answer: B
Rationale: The nurse's priority action when a client diagnosed with angina pectoris complains of chest pain while taking a brisk walk is to have the client sit down. Sitting down reduces the workload on the heart and may alleviate pain by improving oxygen supply. This action aims to reduce the strain on the heart and improve oxygen delivery to the myocardium, which can help relieve the symptoms of angina pectoris. Administering nitroglycerin could be the next step after having the client sit down if the pain persists. Obtaining an electrocardiogram and applying oxygen are not the immediate priority actions when dealing with angina pectoris symptoms.
The primary care NP performs a physical examination on an 89-year-old patient who is about to enter a skilled nursing facility. The patient reports having had chickenpox as a child. The NP should:
- A. obtain a varicella titer.
- B. administer the Varivax vaccine.
- C. give the patient the Zostavax vaccine.
- D. plan to prescribe Zovirax if the patient is exposed to shingles.
Correct Answer: C
Rationale: The correct answer is C because Zostavax is recommended for adults over 60 to prevent shingles, regardless of prior chickenpox. Choice A is incorrect (titer not needed). Choice B is wrong (Varivax not for shingles). Choice D is inaccurate (prophylaxis not standard).
The client is receiving heparin therapy for deep vein thrombosis (DVT). Which lab test should be monitored to evaluate the effectiveness of heparin?
- A. Prothrombin time (PT)
- B. International normalized ratio (INR)
- C. Activated partial thromboplastin time (aPTT)
- D. Fibrinogen levels
Correct Answer: C
Rationale: Activated partial thromboplastin time (aPTT) is the appropriate lab test to monitor the therapeutic effectiveness of heparin therapy. Heparin affects the intrinsic pathway of the coagulation cascade, and monitoring aPTT helps ensure the client is within the therapeutic range to prevent clot formation. Prothrombin time (PT) and International normalized ratio (INR) are used to monitor warfarin therapy, a different anticoagulant that affects the extrinsic pathway of the coagulation cascade. Fibrinogen levels are not specific to monitoring heparin therapy.
A CNM:
- A. may treat only women.
- B. has prescriptive authority in all 50 states.
- C. may administer only drugs used during labor and delivery.
- D. may practice only in birthing centers and home birth settings.
Correct Answer: B
Rationale: The correct answer is B because CNMs have prescriptive authority in all 50 states. Choice A is incorrect as they can treat partners for STDs. Choice C is wrong since their authority isn’t limited to labor drugs. Choice D is inaccurate as they practice in various settings.
A client has a new prescription for transdermal nitroglycerin patches. Which of the following instructions should be included for proper use?
- A. Apply the patch to the same site each day.
- B. Place the patch on an area of skin away from skin folds and joints.
- C. Keep the patch on 24 hours per day.
- D. Replace the patch every 72 hours.
Correct Answer: B
Rationale: Placing the nitroglycerin patch on an area of skin away from skin folds and joints is crucial to ensure optimal absorption and effectiveness of the medication. Placing the patch on skin folds or joints can interfere with absorption, potentially reducing the patch's efficacy. Therefore, it is essential to follow this instruction to maximize the therapeutic benefits of the nitroglycerin patches. The other options are incorrect because applying the patch to the same site each day can lead to skin irritation, keeping the patch on 24 hours per day may not be necessary depending on the specific patch instructions, and replacing the patch every 72 hours is not the standard frequency for nitroglycerin patches.