Nokea
Identify poor metabolizers of tamoxifen
- A. Not provided in document
- B. Not provided in document
- C. Not provided in document
- D. Not provided in document
Correct Answer: C
Rationale: This question lacks options, but the answer key (ANS: 3) indicates the third choice. Poor metabolizers of tamoxifen can be identified through CYP2D6 genotyping, as this enzyme converts tamoxifen to its active metabolite.
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When using a bar-code point-of-care medication system, the nurse would scan which of the following prior to drug administration?(Select one that does not apply.)
- A. Client's hospital chart
- B. Client's identification band
- C. Drug unit dose package
- D. Nurse's identification badge
Correct Answer: A
Rationale: The bar-code point-of-care medication system requires that the client's identification band, the drug unit dose package, and the nurse's identification badge are all scanned prior to drug administration.
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.
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.
Under new U.S. Food and Drug Administration labeling, Pregnancy Categories will be:
- A. Strengthened with a new coding such as C+ or C- to discern when a drug is more or less toxic to the fetus
- B. Changed to incorporate a pregnancy risk summary and clinical considerations on the drug label
- C. Eliminated, and replaced with a link to the National Library of Medicine TOXNET Web site for in-depth information regarding pregnancy concerns
- D. Clarified to include information such as safe dosages in each trimester of pregnancy
Correct Answer: B
Rationale: FDA replaced categories with risk summaries and clinical considerations for clearer, narrative-based guidance, effective 2015.
The average starting dose of warfarin is 5 mg daily. Higher doses of 7.5 mg daily should be considered in which patients?
- A. Pregnant women
- B. Elderly men
- C. Overweight or obese patients
- D. Patients with multiple comorbidities
Correct Answer: C
Rationale: Overweight/obese patients may need higher warfarin doses due to larger volume of distribution; pregnancy contraindicates warfarin.