Nokea
Drugs bound to albumin are inactive.
- A. TRUE
- B. FALSE
Correct Answer: A
Rationale: True; drugs bound to albumin are inactive as only the free (unbound) fraction can interact with receptors or be metabolized/excreted.
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A community health nurse visits a client at home. Prednisone 10 mg orally daily has been prescribed for the client and the nurse reinforces teaching for the client about the medication. Which statement, if made by the client, indicates that further teaching is necessary?
- A. I can take aspirin or my antihistamine if I need it.'
- B. I need to take the medication every day at the same time.'
- C. I need to avoid coffee, tea, cola, and chocolate in my diet.'
- D. If I gain more than 5 pounds a week, I will call my doctor.'
Correct Answer: A
Rationale: Aspirin and other over-the-counter medications should not be taken unless the client consults with the health care provider (HCP). The client needs to take the medication at the same time every day and should be instructed not to stop the medication. A slight weight gain as a result of an improved appetite is expected, but after the dosage is stabilized, a weight gain of 5 lb or more weekly should be reported to the HCP. Caffeine-containing foods and fluids need to be avoided because they may contribute to steroid-ulcer development.
The reason that two MMR vaccines at least a month apart are recommended is:
- A. The second dose of MMR 'boosts' the immunity built from the first dose
- B. Two vaccines 1 month apart is the standard dosing for all live virus vaccines
- C. If the two MMR vaccine doses are given too close together there is a greater likelihood of severe localized reaction to the vaccine
- D. Only 95% of patients are fully immunized for measles after the first vaccine, with 99% having immunity after two doses of MMR
Correct Answer: D
Rationale: Two MMR doses ensure 99% immunity, as 95% respond to one dose; boosting is secondary to this goal.
The student nurse asks the instructor why a patient with a central nervous system infection is receiving antibiotics that will not cross the blood-brain barrier. What is the instructor's most correct response?
- A. A severe infection alters the blood-brain barrier to allow the drug to cross.
- B. A medication that is water soluble is more likely to cross the blood-brain barrier.
- C. Antibiotics are the exception to the blood-brain barrier and cross easily.
- D. An infection that spreads outside the central nervous system helps drugs cross the barrier.
Correct Answer: A
Rationale: Effective antibiotic treatment can occur only when the infection is severe enough to alter the blood-brain barrier and allow antibiotics to cross. Lipid-soluble, not water-soluble, medications cross the blood-brain barrier more easily and most antibiotics are lipid soluble, so they are not the exception. No matter where the infection originates, drugs must cross the blood-brain barrier to treat central nervous system infections.
A nurse is preparing to initiate IV therapy for an older adult client. Which of the following actions should the nurse plan to take?
- A. Use a disposable razor to remove excess hair on the extremity.
- B. Select the back of the client's hand to the catheter.
- C. Entered the veins by using a blood pressure cuff.
- D. Direct the client to raise his arm above his heart
Correct Answer: B
Rationale: The back of the hand is a common site for older adults due to accessible veins and reduced risk of complications.
Amphetamine should not be taken with.....
- A. Paracetamol
- B. Aspirin
- C. MAO inhibitors
- D. Benzimidazole
Correct Answer: C
Rationale: Amphetamines combined with MAO inhibitors can cause a hypertensive crisis due to excessive catecholamine accumulation, a well-known dangerous interaction.