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In today's healthcare environment there is often more contact between the patient and the nurse than between the patient and the physician. What does this make the nurse in the best position to do?
- A. Assess the patient's inability to document medication taken
- B. Assess the patient's inability to communicate with caregivers
- C. Assess the therapeutic success of the drug therapy
- D. Assess the patient's reluctance to purchase the prescribed drug
Correct Answer: C
Rationale: Frequent contact positions nurses to evaluate drug therapy success through direct observation and patient feedback.
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While collecting a medication history, the patient admits to doubling the recommended dosage of an over-the-counter (OTC) medication, saying It's harmless or they would require a prescription. What is the nurse's best response?
- A. OTC drugs are serious medications and carry serious risks if not taken as directed.
- B. Taking medications like that is careless and you could kill yourself doing it.
- C. Sometimes you need to take more than the package directs to treat the symptoms.
- D. Did you notify your doctor of the increased dosage you were taking?
Correct Answer: A
Rationale: OTC drugs are no less a medication than prescription drugs and carry the same types of risks for overdosage and toxicity if directions are not followed. Although increasing the dosage is careless and dangerous, it is important to use the information as a teaching opportunity rather than scolding the patient. Agreeing with the patient or asking her if she talked to the doctor misses the teaching opportunity, which could be harmful for the patient.
A patient is being treated with isoniazid (INH), rifampin, and pyrazinamide in phase I of treatment for tuberculosis. The organism develops resistance to isoniazid. Which drug will the nurse anticipate the provider will order to replace the isoniazid?
- A. Ciprofloxacin (Cipro)
- B. Ethambutol (Myambutol)
- C. Kanamycin
- D. Streptomycin sulfate
Correct Answer: B
Rationale: Ethambutol replaces INH in phase I if resistance occurs; ciprofloxacin or kanamycin are less common first-line options. If there is bacterial resistance to isoniazid, the first phase may be changed to ethambutol, rifampin, and pyrazinamide.
Oral iron supplements are prescribed for a 6 year-old child with iron deficiency anemia. The nurse instructs the mother to administer the iron with which best food item?
- A. Milk
- B. Water
- C. Apple juice
- D. Orange juice
Correct Answer: D
Rationale: Vitamin C increases the absorption of iron by the body. The mother should be instructed to administer the medication with a citrus fruit or a juice that is high in vitamin C. Milk may affect absorption of the iron. Water will not assist in absorption. Orange juice contains a greater amount of vitamin C than apple juice.
A nurse is caring for a client who is admitted to undergo a surgical procedure. Which of the following preexisting conditions can be a contraindication for the use of Ketamine as an intravenous anesthetic?
- A. Peptic ulcer disease
- B. Breast cancer
- C. Diabetes mellitus
- D. Schizophrenia
Correct Answer: D
Rationale: Ketamine can exacerbate schizophrenia due to its psychomimetic effects.
A nursing student is reviewing information about the Controlled Substances Act of 1970. The student would expect to find which of the following as being regulated for drugs classified as controlled substances? Select one that does not apply
- A. Manufacturing
- B. Elimination
- C. Distribution
- D. Dispensing the drug
Correct Answer: B
Rationale: The Controlled Substances Act of 1970 regulates the manufacture, distribution, and dispensing of drugs classified as controlled substances. Elimination refers to the excretion of drugs from the body, a pharmacokinetic activity. The act does not address formulation of the drug.