Nokea
Jack, age 8, has attention deficit disorder (ADD) and is prescribed methylphenidate (Ritalin). He and his parents should be educated about the side effects of methylphenidate, which are:
- A. Slurred speech and insomnia
- B. Bradycardia and confusion
- C. Dizziness and orthostatic hypotension
- D. Insomnia and decreased appetite
Correct Answer: D
Rationale: Insomnia and appetite suppression are common methylphenidate side effects.
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Long-term monitoring of patients who are taking carbamazepine includes:
- A. Routine troponin levels to assess for cardiac damage
- B. Annual eye examinations to assess for cataract development
- C. Monthly pregnancy tests for all women of childbearing age
- D. Complete blood count every 3 to 4 months
Correct Answer: D
Rationale: CBC monitoring detects carbamazepine-induced blood dyscrasias.
The clinic nurse is reviewing a teaching plan for the client receiving an antineoplastic medication. When implementing the plan, the nurse tells the client:
- A. To take aspirin (acetylsalicylic acid) as needed for headache
- B. Drink beverages containing alcohol in moderate amounts each evening
- C. Consult with health care providers (HCPs) before receiving immunizations
- D. That it is not necessary to consult HCPs before receiving a flu vaccine at the local health fair
Correct Answer: C
Rationale: Because antineoplastic medications lower the resistance of the body, clients must be informed not to receive immunizations without a HCP's approval. Clients also need to avoid contact with individuals who have recently received a live virus vaccine. Clients need to avoid aspirin and aspirin-containing products to minimize the risk of bleeding, and they need to avoid alcohol to minimize the risk of toxicity and side effects.
The nurse observes that after administration of a drug the patient has developed itching and a skin rash. The nurse interprets these findings as which of the following?
- A. Toxicity
- B. Allergic reaction
- C. Angioedema
- D. Crystalluria
Correct Answer: B
Rationale: Allergic reactions are manifested by a variety of signs and symptoms including itching, skin rashes, and hives. Swollen eyelids, lips, and mouth are some of the symptoms of angioedema, an allergic drug reaction that may block the airway, causing asphyxia. Toxicity or toxic reactions are caused when blood concentration levels exceed the therapeutic level of drugs. Reduced blood pressure is called hypotension. Crystals in the urine are symptoms of crystalluria.
The telephone triage nurse receives a call from a patient asking for a prescription for a narcotic to manage his surgical pain. The nurse explains that narcotic prescriptions must be written and cannot be called in to the pharmacy. The patient says, Why are narcotics so difficult to get a prescription for? What is the nurses best response?
- A. The Drug Enforcement Agency (DEA) determines the risk for addiction and the Food and Drug Administration (FDA) enforces their control.
- B. The increase in the number of drug addicts has made the rules stronger.
- C. The Centers for Disease Control and Prevention (CDC) regulates use of controlled substances to reduce the risk of injury.
- D. Controlled substances like narcotics are controlled by the FDA and the DEA.
Correct Answer: D
Rationale: Controlled substances are controlled by the FDA and the DEA: the DEA enforces control while the FDA determines abuse potential. Regulations related to controlled substances have remained strict and specific and have not been significantly impacted by substance abusers. The CDC is not involved in control of narcotics and other controlled substances.
A nurse is preparing to administer a medication to a client who has absence seizures. The nurse should anticipate administering which of the following medications?
- A. Phenytoin
- B. Ethosuximide
- C. Gabapentin
- D. Carbamazepine
Correct Answer: B
Rationale: Ethosuximide , valproic acid , and lamotrigine are effective for absence seizures.