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During what phase of the nursing process would the nurse be required to consider the efficacy of nursing interventions related to drug therapy?
- A. Assessment
- B. Nursing diagnosis
- C. Interventions
- D. Evaluation
Correct Answer: D
Rationale: Evaluation assesses the effectiveness of interventions, including drug therapy outcomes, to determine if goals are met.
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The patient, diagnosed with cancer, is receiving morphine sulfate (a potent narcotic pain reliever) to relieve cancer pain. Approximately every 7 days the medication is no longer effective in controlling the patient's pain and a larger dose is needed to have the same effect. How might the nurse explain why this is happening?
- A. Tolerance
- B. Cumulation
- C. Interactions
- D. Addiction
Correct Answer: A
Rationale: The body may develop a tolerance to some drugs over time. Tolerance may arise because of increased biotransformation of the drug, increased resistance to its effects, or other pharmacokinetic factors. When tolerance occurs, the amount of the drug no longer causes the same reaction. Therefore, increasingly larger doses are needed to achieve a therapeutic effect. Cumulative effect occurs when the drug is not properly eliminated and more of the drug is administered, resulting in toxic levels accumulating. Interactions occur when the drug reacts badly with another substance such as food, another drug, or an alternative or complementary therapy. Addiction is the psychological need for a substance.
Adherence to beta blocker therapy may be affected by their:
- A. Short half-lives requiring twice daily dosing
- B. Tendency to elevate lipid levels
- C. Effects on the male genitalia, which may produce impotence
- D. None of the above
Correct Answer: C
Rationale: Impotence is a known side effect that can reduce adherence to beta blockers.
Insuline:
- A. Facilitate glucose absorbtion in the small intestines
- B. Increase sensitivity of insuline receptors
- C. Facilitate glucose permeability in the cell and utilization
- D. Increase glycogen storage
Correct Answer: C
Rationale: Insulin facilitates glucose permeability and utilization and increases glycogen synthesis in cells.
A nurse is preparing to administer a prescribed medication to a client. The nurse integrates knowledge of which of the following as a possible factor that could influence the drug response?
- A. Age
- B. Polypharmacy
- C. Weight
- D. All the above
Correct Answer: D
Rationale: Drug response can be influenced by the following factors: age, polypharmacy, weight, sex, disease, and genetics.
A 25-year-old woman comes to the clinic complaining of rapid heart rate and easy fatigability. Laboratory results reveal low hemoglobin levels and microcytic red blood cells. The most suitable therapy for her condition will be:
- A. Folic acid
- B. Epoiten alfa
- C. Ferrous sulfate
- D. Vitamin B12
Correct Answer: C
Rationale: Microcytic anemia suggests iron deficiency; ferrous sulfate is the standard treatment.