Nokea
Drugs that should be avoided in the elderly include:
- A. Acetaminophen
- B. Amitriptyline
- C. Amoxicillin
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because amitriptyline, a tricyclic antidepressant, is avoided in the elderly (per Beers Criteria) due to anticholinergic effects causing confusion, constipation, and falls. Choice A is incorrect as acetaminophen is safe. Choice C is wrong because amoxicillin is appropriate with dose adjustment. Choice D is incorrect since only amitriptyline fits.
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A client with a diagnosis of heart failure is prescribed spironolactone (Aldactone). Which laboratory value should the nurse monitor closely?
- A. Serum calcium
- B. Serum potassium
- C. Serum sodium
- D. Serum glucose
Correct Answer: B
Rationale: The correct answer is B: Serum potassium. Spironolactone is a potassium-sparing diuretic, which can lead to hyperkalemia. Monitoring serum potassium levels is crucial to prevent potential complications related to high potassium levels, such as cardiac arrhythmias. Therefore, close monitoring of serum potassium is essential for clients taking spironolactone. Choices A, C, and D are incorrect because spironolactone does not directly impact serum calcium, sodium, or glucose levels significantly. While these values may be monitored for other reasons in a client with heart failure, they are not the primary focus of monitoring when spironolactone is prescribed.
The parent of a 3-year-old is concerned that the child's legs are not straight. The primary care NP notes marked bowing of the child's lower extremities. Radiologic studies show decreased ossification of the child's bones. The NP should:
- A. prescribe vitamin D supplements.
- B. recommend calcium supplements.
- C. counsel the parent to increase the child's milk intake.
- D. ensure that the parent is buying vitamin D-fortified milk.
Correct Answer: A
Rationale: The correct answer is A because vitamin D deficiency causes rickets, leading to bowing legs, corrected with supplements. Choice B is incorrect (calcium needs vitamin D). Choice C is wrong (milk alone insufficient). Choice D is inaccurate (fortified milk not enough).
Strategies to avoid counterfeit drugs include:
- A. Purchasing from licensed pharmacies
- B. Checking drug packaging
- C. Avoiding online purchases from unverified sources
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because using licensed pharmacies (regulated supply), checking packaging (authenticity cues), and avoiding unverified online sources (high-risk) all prevent counterfeit drug use, per FDA advice. Choice A is incorrect alone as it's one strategy. Choice B is wrong by itself because packaging is just part. Choice C is incorrect solo since online avoidance is only one method.
The NP chooses to give cephalexin every 8 hours based on knowledge of the drug's:
- A. Propensity to go to the target receptor
- B. Biological half-life
- C. Pharmacodynamics
- D. Safety and side effects
Correct Answer: B
Rationale: Choice B is correct because dosing cephalexin every 8 hours aligns with its biological half-life, the time it takes for half the drug to be eliminated, ensuring steady therapeutic levels. Choice A is incorrect as ‘propensity to target receptor' isn't a standard pharmacokinetic term for dosing decisions. Choice C is wrong because pharmacodynamics (drug effects) informs efficacy, not timing. Choice D is incorrect since safety and side effects influence drug choice, not specifically the 8-hour interval.
A client diagnosed with thrombophlebitis 1 day ago suddenly complains of chest pain and shortness of breath. The LPN/LVN understands that a life-threatening complication of this condition is which?
- A. Pneumonia
- B. Pulmonary edema
- C. Pulmonary embolism
- D. Myocardial infarction
Correct Answer: C
Rationale: The correct answer is C, Pulmonary embolism. Pulmonary embolism is a critical complication of thrombophlebitis where a blood clot dislodges and travels to the lungs, obstructing blood flow. This obstruction can lead to chest pain, shortness of breath, and potentially fatal consequences, making it a life-threatening emergency that requires prompt intervention. Choices A, B, and D are incorrect because pneumonia, pulmonary edema, and myocardial infarction are not directly associated with thrombophlebitis and would not present with the sudden onset of chest pain and shortness of breath in this context.