Medication agreements or 'Pain Medication Contracts' are recommended to be used:
- A. Universally for all prescribing for chronic pain
- B. For patients who have repeated requests for pain medication
- C. When you suspect a patient is exhibiting drug-seeking behavior
- D. For patients with pain associated with malignancy
Correct Answer: A
Rationale: Pain contracts are recommended universally for chronic pain to set expectations, not just for repeated requests , suspicion , or cancer .
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Potentially fatal granulocytopenia has been associated with treatment of hyperthyroidism with propylthiouracil. Patients should be taught to report:
- A. Tinnitus and decreased salivation
- B. Fever and sore throat
- C. Hypocalcemia and osteoporosis
- D. Laryngeal edema and difficulty swallowing
Correct Answer: B
Rationale: Fever and sore throat signal granulocytopenia with propylthiouracil; other symptoms are unrelated.
Phenytoin decreases folic acid absorption by:
- A. Altering the pH of the stomach
- B. Increasing gastric emptying time
- C. Inhibiting intestinal enzymes required for folic acid absorption
- D. Chelation of the folic acid into inactive ingredients
Correct Answer: C
Rationale: Phenytoin inhibits intestinal conjugase enzymes, reducing folic acid absorption.
Scott's seizures are well controlled on topiramate and he wants to start playing baseball. Education for Scott regarding his topiramate includes:
- A. He should not play sports due to the risk of increased seizures
- B. He should monitor his temperature and ability to sweat in the heat while playing
- C. Reminding him that he may need higher dosages of topiramate when exercising
- D. Encouraging him to use sunscreen due to photosensitivity from topiramate
Correct Answer: B
Rationale: Topiramate can impair sweating, increasing heat-related risks during sports.
The processes involved in dynamic equilibrium are key elements in the nurse's ability to determine what?
- A. Dosage scheduling
- B. Amount of solution for mixing parenteral drugs
- C. Timing of other drugs the patient is taking
- D. How long the patient has to take the drug
Correct Answer: A
Rationale: These processes are key elements in determining the amount of drug (dose) and the frequency of dose repetition (scheduling) required to achieve the critical concentration for the desired length of time. The processes in dynamic equilibrium are not key elements in determining the amount of diluents for intramuscular (IM) drugs; they do not aid in the timing of the other drugs the patient is taking or how long the patient has to take the drug.
A nurse is assisting with caring for a client with cancer who is receiving cisplatin. Select the adverse effects that the nurse monitors for that are associated with this medication. (Select one that does not apply.)
- A. Tinnitus
- B. Ototoxicity
- C. Hyperkalemia
- D. Hypomagnesemia
Correct Answer: C
Rationale: Cisplatin is an alkylating medication. Alkylating medications are cell cycle phase-nonspecific medications that affect the synthesis of DNA by causing the cross-linking of DNA to inhibit cell reproduction. Cisplatin may cause ototoxicity, tinnitus, hypokalemia, hypocalcemia, hypomagnesemia, and nephrotoxicity. Amifostine (Ethyol) may be administered before cisplatin to reduce the potential for renal toxicity. Correct answers include: 1 (Tinnitus), 2 (Ototoxicity), 5 (Nephrotoxicity), 6 (Hypomagnesemia).