Janice has elevated LDL, VLDL, and triglyceride levels. Niaspan, an extended-release form of niacin, is chosen to treat her hyperlipidemia. Due to its metabolism and excretion, which of the following laboratory results should be monitored?
- A. Serum alanine aminotransferase
- B. Serum amylase
- C. Serum creatinine
- D. Phenylketonuria
Correct Answer: A
Rationale: Niacin can cause hepatotoxicity, requiring ALT monitoring.
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A patient who has AIDS is at risk to contract aspergillosis. The nurse will anticipate that which antifungal medication will be ordered prophylactically for this patient?
- A. Metronidazole (Flagyl)
- B. Micafungin (Mycamine)
- C. Posaconazole (Noxafil)
- D. Voriconazole (Vfend)
Correct Answer: C
Rationale: Posaconazole prevents Aspergillus in AIDS; micafungin or voriconazole treat, not prevent. Posaconazole is given for prophylactic treatment of Aspergillus and Candida infections.
The client with small cell lung cancer is being treated with etoposide (VePesid). The nurse who is assisting in caring for the client during its administration understands that which side effect is specifically associated with this medication?
- A. Alopecia
- B. Chest pain
- C. Pulmonary fibrosis
- D. Orthostatic hypotension
Correct Answer: D
Rationale: A side effect specific to etoposide is orthostatic hypotension. The client's blood pressure is monitored during the infusion. Hair loss occurs with nearly all the antineoplastic medications. Chest pain and pulmonary fibrosis are unrelated to this medication.
Tuberculin purified protein derivative:
- A. Is administered to patients who are known tuberculin-positive reactors
- B. May be administered to patients who are on immunosuppressives
- C. May be administered 2 to 3 weeks after an MMR or varicella vaccine
- D. May be administered the same day as the MMR and/or varicella vaccine
Correct Answer: D
Rationale: TB skin test can be given same-day as MMR/varicella; prior positives or immunosuppression complicate interpretation.
A nurse is caring for a patient who is supposed to receive two drugs at the same time. What is the nurse's priority action?
- A. Wash her hands before handling the medications.
- B. Consult a drug guide for compatibility.
- C. Question the patient concerning drug allergies.
- D. Identify the patient by checking the armband and asking the patient to state his name.
Correct Answer: B
Rationale: A nurse should first consult a drug guide for compatibility when two or more drugs are being given at the same time. After compatibility is determined the medication can be administered. The nurse will perform hand hygiene, check for patient allergies, and ensure the right patient receives the medication by using two identifiers.
Which of the following drugs should be avoided in a pregnant woman because of a risk of harming the fetus?
- A. Pravastatin
- B. Cholestyramine
- C. Gemfibrozil
- D. Niacin
Correct Answer: A
Rationale: Statins like pravastatin are contraindicated in pregnancy due to potential teratogenic effects.
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