Nokea
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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The following drugs may precipitate angina pectoris EXCEPT:
- A. Amphetamine
- B. Hydralazine
- C. Isoproterenol
- D. Epinephrine
Correct Answer: D
Rationale: Propranolol, a beta-blocker, relieves angina, unlike the others which increase cardiac demand.
Colestipol comes in a powdered form. The patient is taught to:
- A. Take the powder dry and follow it with at least 8 ounces of water
- B. Take it with a meal to enhance its action on fatty food
- C. Mix the powder with 4 to 6 ounces of milk or fruit juice
- D. Take after the evening meal to coincide with cholesterol synthesis
Correct Answer: C
Rationale: Mixing colestipol with liquid improves palatability and administration.
A nurse is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is vancomycin 1 g in 100 mL of dextrose 5% in water (D5W) to infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should adjust the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Do not use a trailing zero.)
- A. 22
- B. 25
- C. 20
- D. 18
Correct Answer: A
Rationale: Calculation: (100 mL / 45 min) 10 gtt/mL = 22.22, rounded to 22 gtt/min, matching the provided answer.
The patient looks at the prescription provided by the doctor and asks the nurse whether he can request a generic substitution. The nurse answers No when noting what on the prescription?
- A. No refills
- B. DAW
- C. Brand name used on prescription
- D. Patient older than 65 years of age
Correct Answer: B
Rationale: DAW stands for dispense as written and means that the doctor does not want a generic substituted for the prescribed medication. Requesting no refills does not preclude the substitution of a generic medication. Even when the brand name is ordered, the pharmacist can substitute a generic equivalent so long as the prescriber does not write DAW. Generic substitutions are not impacted by the patients age.
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.