Nokea
Discharge summaries using information technology have several advantages. They can:
- A. Replace the need for oral instruction because the patient has printed material to read at home
- B. Be filed with the patient's chart to document patient teaching
- C. Both 1 and 2
- D. Neither 1 nor 2
Correct Answer: B
Rationale: IT discharge summaries document teaching but do not replace oral instructions.
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Protein binding of a drug helps in
- A. Distribution
- B. Prolonging half life
- C. Limiting metabolism
- D. All of the above
Correct Answer: D
Rationale: Protein binding affects distribution (bound drugs stay in plasma), prolongs half-life (less free drug available for clearance), and limits metabolism (bound drug is less accessible to enzymes).
A low-carbohydrate, high-protein diet may:
- A. Increase drug-metabolizing enzymes
- B. Decrease drug absorption from the GI tract
- C. Alter drug binding to plasma proteins
- D. Enhance drug elimination
Correct Answer: A
Rationale: High-protein diets can induce hepatic enzymes (e.g., CYP450), increasing drug metabolism.
The nurse is caring for a patient who takes several drugs. What patient would the nurse monitor most closely because of an increased risk for adverse effects of medications?
- A. The school-aged child
- B. The obese middle-aged man
- C. The adolescent
- D. The newborn infant
Correct Answer: D
Rationale: Newborns have immature organs, increasing risk for adverse effects from multiple drugs.
A nurse is caring for a client who takes Paroxetine to treat PTSD and reports that he grinds his teeth during the night. The nurse should identify which of the following interventions to manage Bruxism? (Select all that apply.)
- A. Concurrent administration of buspirone
- B. Administration of a different SSRI
- C. Use of a mouth guard
- D. Changing to a different class of antidepressant medication
Correct Answer: C
Rationale: A mouth guard is a practical intervention for bruxism; medication changes may not address it directly.
The nurse observes that after administration of a drug the patient has developed itching and a skin rash. The nurse interprets these findings as which of the following?
- A. Toxicity
- B. Allergic reaction
- C. Angioedema
- D. Crystalluria
Correct Answer: B
Rationale: Allergic reactions are manifested by a variety of signs and symptoms including itching, skin rashes, and hives. Swollen eyelids, lips, and mouth are some of the symptoms of angioedema, an allergic drug reaction that may block the airway, causing asphyxia. Toxicity or toxic reactions are caused when blood concentration levels exceed the therapeutic level of drugs. Reduced blood pressure is called hypotension. Crystals in the urine are symptoms of crystalluria.