Nokea
Drug errors are most likely to occur at which time? Select one that does not that apply.
- A. When transcribing the drug order
- B. When verifying the client
- C. When dispensing the drug
- D. When the drug is administered
Correct Answer: B
Rationale: Drug errors may occur in transcribing drug orders, when the drug is dispensed, or in administration of the drug. Nurses, as the drug administrators, serve as the last defense against drug errors. Verifying the client and charting after administration are two important areas to help prevent medication errors.
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The U.S. Food and Drug Administration MedWatch system is activated when:
- A. There is an adverse event to a vaccine.
- B. The patient has a severe reaction that is noted in the 'Severe Reaction' section in the medication label.
- C. A lactating woman takes a medication that is potentially toxic to the breastfeeding infant.
- D. An adverse event or serious problem occurs with a medication that is not already identified on the label.
Correct Answer: D
Rationale: MedWatch reports new, unlabeled adverse events , beyond vaccines , known reactions , or lactation risks .
Which cephalosporin is often used to treat complicated skin and soft tissue infections?
- A. Cefazolin
- B. Cefepime
- C. Ceftaroline
- D. Cephalexin
Correct Answer: C
Rationale: Ceftaroline, a fifth-generation cephalosporin, is effective against complicated skin/soft tissue infections, including MRSA.
A patient requires 1,000 mL of IV fluid to be infused over 10 hours with a drop factor of 20 gtt/mL. What is the flow rate in drops per minute?
- A. 33 gtt/min
- B. 50 gtt/min
- C. 67 gtt/min
- D. 100 gtt/min
Correct Answer: A
Rationale: Flow rate = (Volume Drop factor) ÷ Time in minutes = (1,000 mL 20 gtt/mL) ÷ (10 60) = 20,000 ÷ 600 = 33.33 gtt/min, rounded to 33 gtt/min.
Which of the following regarding E max is correct?
- A. E max assumes that as long as you increase the concentration of the drug, there will be a higher effect of the drug
- B. E max is used to compare the potency of different drugs
- C. E max assumes that all receptors are occupied by the drug and no increase in response is observed if a higher concentration of drug is obtained
- D. All of the previous points are incorrect
Correct Answer: C
Rationale: Emax is the maximal effect when all receptors are occupied; further dose increases yield no additional effect.
A nurse is caring for a patient who has been receiving a drug by the intramuscular route but will receive the drug orally after discharge. How does the nurse explain the increased dosage prescribed for the oral dose?
- A. Passive diffusion
- B. Active transport
- C. Glomerular filtration
- D. First-pass effect
Correct Answer: D
Rationale: The first-pass effect involves drugs that are absorbed from the small intestine directly into the portal venous system, which delivers the drug molecules to the liver. After reaching the liver, enzymes break the drug into metabolites, which may become active or may be deactivated and readily excreted from the body. A large percentage of the oral dose is usually destroyed and never reaches tissues. Oral dosages account for the phenomenon to ensure an appropriate amount of the drug in the body to produce a therapeutic action. Passive diffusion is the major process through which drugs are absorbed into the body. Active transport is a process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney. Glomerular filtration is the passage of water and water-soluble components from the plasma into the renal tubule.