Nokea
Digoxin levels need to be monitored closely when the following medication is started:
- A. Loratadine
- B. Diphenhydramine
- C. Ipratropium
- D. Albuterol
Correct Answer: D
Rationale: Albuterol , a beta-agonist, can increase digoxin levels by enhancing its effects, requiring close monitoring; antihistamines and ipratropium have minimal impact.
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A child with severe asthma is being treated oral prednisone. Which of the following adverse effects is of particular concern?
- A. Hypoglycemia
- B. Hirsutism
- C. Growth suppression
- D. Cushing syndrome
Correct Answer: C
Rationale: Growth suppression is a significant concern in children on long-term prednisone due to its impact on bone growth and development.
A nurse is caring for a client who has been taking Sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing Serotonin syndrome?
- A. Bruising
- B. Fever
- C. Abdominal pain
- D. Rash
Correct Answer: B
Rationale: Fever is a key sign of serotonin syndrome, a potentially life-threatening condition from SSRI overdose.
The nurse is assessing a client with diabetes who reports several hypoglycemic episodes during the past 3 weeks. What assessment question best addresses a potential causative factor?
- A. Do you ever take St. John's wort?'
- B. Have you used any recreational drugs in the past few weeks?'
Correct Answer: A
Rationale: St. John's wort can affect glucose metabolism and drug interactions, potentially causing hypoglycemia in diabetics.
Zero order kinetics is seen with
- A. Phenytoin
- B. Phenobarbital
- C. Erythromycin
- D. Digoxin
Correct Answer: A
Rationale: Phenytoin exhibits zero-order kinetics at high doses (rate is constant, not proportional).
The FDA issued a safety announcement regarding the use of erythropoiesis-stimulating agents (ESAs) in 2010 with the recommendation that:
- A. ESAs no longer be prescribed to patients with chronic renal failure
- B. The risk of tumor development be explained to cancer patients on ESA therapy
- C. Patients should no longer receive ESA therapy to prepare for allogenic transfusions
- D. ESAs be prescribed only to patients staying
Correct Answer: B
Rationale: The 2010 FDA warning highlighted tumor progression risks in cancer patients on ESAs; renal use continues with caution.