Nokea
Drugs do not metabolize the same way in all people. For what patient would a nurse expect to assess for an alteration in drug metabolism?
- A. A 35-year-old woman with cervical cancer
- B. A 41-year-old man with kidney stones
- C. A 50-year-old man with cirrhosis of the liver
- D. A 62-year-old woman in acute renal failure
Correct Answer: C
Rationale: The liver is the most important site of drug metabolism. If the liver is not functioning effectively, as in patients with cirrhosis, drugs will not metabolize normally so that toxic levels could develop unless dosage is reduced. A patient with cervical cancer or kidney stones would not be expected to have altered ability to metabolize drugs so long as no liver damage existed. The patient with renal failure would have altered excretion of the drugs through the renal system but metabolism would not be impacted.
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A nurse is caring for a child on the pediatric unit. A drug is ordered for the child, but no pediatric dose is listed for the drug. To make sure that the right dose has been ordered, what will the nurse use to calculate the correct dose?
- A. Surface area
- B. Height
- C. Birth date
- D. Adult dosage
Correct Answer: A
Rationale: Pediatric doses are often calculated using body surface area for accuracy, especially when no specific pediatric dose is provided.
Charlie is a 65-year-old male who has been diagnosed with hypertension and benign prostatic hyperplasia. Doxazosin has been chosen to treat his hypertension because it:
- A. Increases peripheral vasoconstriction
- B. Decreases detrusor muscle contractility
- C. Lowers supine blood pressure more than standing pressure
- D. Relaxes smooth muscle in the bladder neck
Correct Answer: D
Rationale: Doxazosin, an alpha-1 blocker, relaxes bladder neck smooth muscle, aiding BPH, and lowers blood pressure.
Oral iron supplements are prescribed for a 6 year-old child with iron deficiency anemia. The nurse instructs the mother to administer the iron with which best food item?
- A. Milk
- B. Water
- C. Apple juice
- D. Orange juice
Correct Answer: D
Rationale: Vitamin C increases the absorption of iron by the body. The mother should be instructed to administer the medication with a citrus fruit or a juice that is high in vitamin C. Milk may affect absorption of the iron. Water will not assist in absorption. Orange juice contains a greater amount of vitamin C than apple juice.
While collecting a medication history, the patient admits to doubling the recommended dosage of an over-the-counter (OTC) medication, saying It's harmless or they would require a prescription. What is the nurse's best response?
- A. OTC drugs are serious medications and carry serious risks if not taken as directed.
- B. Taking medications like that is careless and you could kill yourself doing it.
- C. Sometimes you need to take more than the package directs to treat the symptoms.
- D. Did you notify your doctor of the increased dosage you were taking?
Correct Answer: A
Rationale: OTC drugs are no less a medication than prescription drugs and carry the same types of risks for overdosage and toxicity if directions are not followed. Although increasing the dosage is careless and dangerous, it is important to use the information as a teaching opportunity rather than scolding the patient. Agreeing with the patient or asking her if she talked to the doctor misses the teaching opportunity, which could be harmful for the patient.
James has hypothalamic-pituitary-adrenal axis suppression from chronic prednisone (a corticosteroid) use. He is at risk for what type of adverse drug reaction?
- A. Type B
- B. Type C
- C. Type E
- D. Type F
Correct Answer: B
Rationale: Chronic prednisone use causing HPA suppression is a Type C (chronic) ADR , linked to prolonged exposure, not idiosyncratic , withdrawal , or failure .