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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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You are going to prescribe a drug and the electronic health record (EHR) alerts you that there is a potential drug-drug interaction. The alert is generated by:
- A. The Food and Drug Administration MedWatch system
- B. TOXNET, the National Institutes of Health alert system
- C. The EHR clinical decision support system
- D. Lexicomp, a commercial medication alert system
Correct Answer: C
Rationale: EHR clinical decision support systems generate real-time drug interaction alerts.
The patient is taking low dose aspirin daily for his heart. The nurse knows only a portion of the medication taken actually reaches the tissue due to what process?
- A. Distribution
- B. First-pass effect
- C. Reduced absorption
- D. Gastrointestinal circulation
Correct Answer: B
Rationale: Drugs that are taken orally are usually absorbed from the small intestine directly into the portal venous system and then delivers these absorbed molecules into the liver, which immediately break the drug into metabolites, some of which are active and cause effects in the body, and some of which are deactivated and can be readily excreted from the body. As a result, a large percentage of the oral dose is destroyed at this point and never reaches the tissues. This process is not caused by distribution, absorption, or gastrointestinal circulation.
Which of the following drug shows foetal hydantoin syndrome?
- A. Alcohol
- B. Phenytoin
- C. Ethosuximide
- D. Phenobarbitone
Correct Answer: B
Rationale: Phenytoin is associated with fetal hydantoin syndrome, characterized by craniofacial abnormalities and growth deficits, due to its teratogenic effects during pregnancy.
The MMR vaccine is not recommended for pregnant women because:
- A. Pregnant women do not build adequate immunity to the vaccine
- B. There is a risk of the pregnant women developing measles encephalopathy
- C. There is a risk of the fetus developing congenital rubella syndrome
- D. Pregnant women can receive the MMR vaccine
Correct Answer: C
Rationale: MMR (live vaccine) risks fetal congenital rubella syndrome ; pregnancy contraindicates it, not immunity or encephalopathy .
When a primary health care provider phones in a medication order for a client, the nurse should do which of the following? (Select one that does not apply.)
- A. Write down the order.
- B. Record the order as soon as the MAR is retrieved.
- C. Repeat back the information exactly as written.
- D. Clarify any unclear information.
Correct Answer: B
Rationale: If a verbal order is given over the telephone, the nurse writes down the order immediately, repeats back the information exactly as written, and then asks for a verbal confirmation that it is correct. Any order that is unclear should be questioned and clarified.