Nokea
Idiosyncrasy is:
- A. A genetically determined abnormal reaction to drugs
- B. A characteristic toxic effect at therapeutic doses
- C. An altered physiological state produced by repeated drug use
- D. An immunologically mediated reaction
Correct Answer: A
Rationale: Idiosyncrasy is a genetically determined unusual response to a drug, e.g., G6PD deficiency with primaquine.
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Patients who are on chronic long-term corticosteroid therapy need education regarding:
- A. Receiving all vaccinations, especially the live flu vaccine
- B. Reporting black tarry stools or abdominal pain
- C. Eating a high carbohydrate diet with plenty of fluids
- D. Small amounts of alcohol are generally tolerated
Correct Answer: B
Rationale: Black tarry stools signal GI bleeding from corticosteroids; live vaccines are contraindicated.
Patrick is a 10-year-old patient who presents with uncomfortable constipation. Along with diet changes, a laxative is ordered to provide more rapid relief of constipation. An appropriate choice of medication for a 10-year-old child would be:
- A. PEG 3350 (Miralax)
- B. Bisacodyl (Dulcolax) suppository
- C. Docusate (Colace) suppository
- D. Polyethylene glycol electrolyte solution
Correct Answer: A
Rationale: PEG 3350 is safe and effective for kids; suppositories (B, C) are less preferred, and PEG solution is for bowel prep.
Vera, age 70, has isolated systolic hypertension. Calcium channel blocker dosages for her should be:
- A. Started at about half the usual dosage
- B. Not increased over the usual dosage for an adult
- C. Given once daily because of memory issues in the older adult
- D. Withheld if she experiences gastroesophageal reflux
Correct Answer: A
Rationale: Elderly patients start at half dose due to reduced metabolism and clearance.
The volume of distribution (Vd) for a drug that is completely retained in the vascular compartment would be?
- A. High
- B. Low
- C. Unchanged
- D. Cannot be determined
Correct Answer: B
Rationale: A drug confined to the vascular compartment (e.g., plasma) has a low Vd, close to plasma volume (about 0.06 L/kg), indicating limited distribution.
Which statement(s) is/are true regarding the types of medication orders? (Select one that does not apply.)
- A. Stat orders are the same as single dose orders.
- B. Verbal orders should be used as much as possible.
- C. Renewal orders facilitate physician review before continuance of high risk medications.
- D. PRN medications will designate a mandatory number of times the medication is to be administered.
Correct Answer: C
Rationale: Standing orders state the frequency of medication dosages to be administered or indicate the time frame of administration. Renewal orders require the physician to review medications that have expired orders, as determined by facility policy. Renewal policies facilitate physician verification of the necessity to continue a medication beyond a usual time frame and help ensure patient safety. Single dose and stat orders are not the same. PRN medications are not ordered a mandatory number of times, although a maximum number might be specified. Verbal orders should be avoided whenever possible.