Nokea
Many patients self-medicate with antacids. Which patients should be counseled to not take calcium carbonate antacids without discussing it with their provider or a pharmacist first?
- A. Patients with kidney stones
- B. Pregnant patients
- C. Patients with heartburn
- D. Postmenopausal women
Correct Answer: A
Rationale: Calcium carbonate can worsen kidney stones; it's generally safe in pregnancy or heartburn without special caution.
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The nurse is caring for a patient who had a severe, acute, previously unseen adverse effect of a drug in Phase III testing. The patient asks, After all the testing done on this drug, didn't they know this adverse effect could occur? What is the nurse's best response? (Select one that does not apply.)
- A. Pharmaceutical companies sometimes underreport problems to make more money.
- B. Your response to this medication will be reported to the drug company and the Food and Drug Administration (FDA).
- C. After a drug reaches phase III testing it is considered an accepted drug and will not be recalled.
- D. The pharmaceutical company weighs the benefits of the drug with the severity of adverse effects.
Correct Answer: B
Rationale: When a new and unexpected adverse effect occurs, especially one of a serious nature, it is reported to the drug company who reports it to the FDA immediately. When a large number of people begin using the drug in phase III studies, it is not unusual to identify adverse effects not previously noted. It would be both unprofessional and inaccurate to imply that pharmaceutical companies put profit ahead of patient concern because lawsuits would remove any potential profit if a drug proves harmful. The FDA is responsible for weighing risk versus benefit in deciding whether to allow the drug to move to the next phase of testing. Drugs found to have serious adverse effects can be removed from the market at any time.
A nurse in an emergency unit is reviewing the medical record of a client who is being evaluated for angle-closure Glaucoma. Which of the following findings are indicative of this condition?
- A. Insidious onset of painless loss of vision
- B. Gradual reduction in peripheral vision
- C. Severe pain around eyes
- D. Intraocular pressure 12 mm Hg
Correct Answer: C
Rationale: Angle-closure glaucoma presents with severe eye pain and elevated pressure, unlike the normal 12 mm Hg.
Which of the following is used for treatment of mixedema:
- A. Triiodthironine
- B. Potassium perchlorate
- C. Mercazolil
Correct Answer: A
Rationale: Triiodothyronine (T3) is used to treat myxedema (severe hypothyroidism) by replacing deficient thyroid hormone.
The client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication?
- A. Glucose level
- B. Calcium level
- C. Potassium level
- D. Prothrombin time
Correct Answer: B
Rationale: Tamoxifen may increase calcium, cholesterol, and triglyceride levels. Before the initiation of therapy, a complete blood count, platelet count, and serum calcium levels should be assessed. These blood levels, along with cholesterol and triglyceride levels, should be monitored periodically during therapy. The nurse should assess for hypercalcemia while the client is taking this medication. Signs of hypercalcemia include increased urine volume, excessive thirst, nausea, vomiting, constipation, hypotonicity of muscles, and deep bone and flank pain.
Monitoring of a patient on gabapentin to treat seizures includes:
- A. Routine therapeutic drug levels every 3 to 4 months
- B. Assessing for dermatologic reactions, including Steven's Johnson
- C. Routine serum electrolytes, especially in hot weather
- D. Recording seizure frequency, duration, and severity
Correct Answer: D
Rationale: Monitoring seizure activity is key to assessing gabapentin efficacy.