Nokea
Management of tolerance includes:
- A. Increasing the dose
- B. Switching to a different drug
- C. Drug holidays
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because increasing doses (short-term fix), switching drugs (new mechanism), and drug holidays (reset sensitivity) all manage tolerance, per clinical strategies. Choice A is incorrect alone as it's one method. Choice B is wrong by itself because switching is just part. Choice C is incorrect solo since holidays are only one option.
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A client has a new prescription for sertraline. Which of the following instructions should the nurse include?
- A. Take the medication in the morning.
- B. Avoid consuming grapefruit juice.
- C. Take the medication with a full glass of water.
- D. Monitor for signs of weight gain.
Correct Answer: B
Rationale: The correct instruction for the nurse to include is to 'Avoid consuming grapefruit juice.' Grapefruit juice can increase sertraline levels, leading to an elevated risk of side effects. Instructing the client to avoid grapefruit juice is crucial to prevent potential interactions that could impact the effectiveness and safety of the medication. The other options are not directly related to sertraline administration. Taking the medication in the morning may vary depending on individual preferences or the prescriber's directions. Taking the medication with a full glass of water is a general instruction for many medications and not specific to sertraline. Monitoring for signs of weight gain is important but not a direct instruction related to taking sertraline.
The primary care NP sees a 4-year-old child who has persistent asthma episodes for a well-child visit in October. The child recently completed a 7-day course of oral steroids. The NP plans to give the child flu vaccine and should:
- A. administer LAIV today.
- B. administer 0.5 mg TIV today.
- C. wait 4 weeks and administer LAIV.
- D. wait 4 weeks and administer 0.5 mg TIV.
Correct Answer: B
Rationale: The correct answer is B because LAIV is contraindicated in asthmatic children aged 2-4; TIV is safe post-steroids. Choice A is incorrect (LAIV excluded). Choice C is wrong (waiting unnecessary). Choice D is inaccurate (waiting not needed).
A client has a new prescription for amlodipine. Which of the following instructions should the nurse include?
- A. Take the medication with food.
- B. Monitor blood pressure daily.
- C. Increase intake of potassium-rich foods.
- D. Avoid consuming grapefruit juice.
Correct Answer: B
Rationale: The correct answer is B: 'Monitor blood pressure daily.' When a client is prescribed amlodipine, it is essential to monitor their blood pressure regularly. Amlodipine is known to cause hypotension, so monitoring blood pressure helps ensure it stays within the desired range to prevent complications associated with low blood pressure. Choice A is incorrect because amlodipine can be taken with or without food. Choice C is incorrect as increasing potassium intake is not a specific instruction related to amlodipine. Choice D is incorrect as grapefruit juice interactions are not typically a concern with amlodipine.
Risk factors for misuse of controlled substances include:
- A. History of substance abuse
- B. Young age
- C. Mental health disorders
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because prior substance abuse, young age (impulsivity), and mental health issues (self-medication) are all established risk factors for misuse, per addiction research. Choice A is incorrect alone as it's one factor. Choice B is wrong by itself because age is just part. Choice C is incorrect solo since mental health is only one aspect.
A female patient who is 8 weeks pregnant is seen by a primary care nurse practitioner (NP) after a routine prenatal screen was positive for human immunodeficiency virus (HIV). A CD4 cell count is 750 cells/mm. The NP should:
- A. begin immediate therapy with zidovudine and lamivudine.
- B. begin therapy with zidovudine when she is in her second trimester.
- C. delay treatment with antiretroviral medications until after her pregnancy.
- D. initiate therapy with zidovudine if her CD4 cell count decreases to 500 cells/mm.
Correct Answer: B
Rationale: The correct answer is B because antiretrovirals like zidovudine are recommended in pregnancy but avoided in the first trimester if possible. Choice A is incorrect (first trimester risk). Choice C is wrong (delay risks transmission). Choice D is inaccurate (CD4 threshold not applicable).