Nokea
Immunomodulators such as azathioprine may cause a delayed adverse drug reaction known as a type D reaction because they are known:
- A. Teratogens
- B. Carcinogens
- C. To cause hypersensitivity reactions
- D. Hypothalamus-pituitary-adrenal axis suppressants
Correct Answer: B
Rationale: Azathioprine's Type D (delayed) ADRs, like cancer risk , emerge long-term, unlike teratogenicity , hypersensitivity , or HPA suppression .
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The nurse is aware that for a drug to work properly on reactive tissues, a sufficient amount of the drug is needed to cause the therapeutic effect. The term used for this amount is:
- A. Critical concentration
- B. Dynamic equilibrium
- C. Selective toxicity
- D. Active transport
Correct Answer: A
Rationale: A critical concentration of a drug must be present before a reaction occurs within our cells. A dynamic equilibrium is obtained from absorption of a drug from the site of drug entry, distribution to the active site, metabolism in the liver, and excretion from the body to have a critical concentration. Selective toxicity is the ability of a drug to attach only to those systems found in foreign cells. Active transport is the process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney.
Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which of the following would indicate the presence of systemic toxicity from this medication?
- A. Tinnitus
- B. Diarrhea
- C. Constipation
- D. Decreased respirations
Correct Answer: A
Rationale: Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and diarrhea are not associated with salicylism.
You are discussing your patient's drug regimen with their primary care provider. The patient has seen two specialists since seeing the primary care provider and been diagnosed with renal impairment. Why would this be important information? (Select one that does not apply.)
- A. Help promote a safe and effective medication regimen
- B. Help prevent medication errors
- C. So the physician can answer family questions
- D. Help prevent adverse effects
Correct Answer: C
Rationale: Renal impairment affects drug clearance, making this information vital to prevent errors , adverse effects , and ensure safety/efficacy . Keeping everyone informed and answering family questions are secondary.
A nurse assessing a client's IV catheter insertion site notes a hematoma. Which of the following actions should the nurse take? (Select all that apply.)
- A. Stop the infusion.
- B. Apply alcohol to the insertion site.
- C. Apply warm compresses to the insertion site
- D. Lower the client's arm.
Correct Answer: C
Rationale: Warm compresses and elevation reduce swelling and promote absorption of a hematoma.
A nurse is providing instructions to a female client who has a new prescription for Zolpidem. Which of the following instructions should the nurse include?
- A. Notify the provider if you plan to become pregnant.
- B. Take the medication 1 hr before you plan to go to sleep.
- C. Allow at least 6 hr for sleep when taking zolpidem.
- D. To increase the effectiveness of zolpidem, take it with a bedtime snack.
Correct Answer: A
Rationale: Pregnancy notification is key due to zolpidem's risks; it's taken just before sleep, needing 7-8 hours.