Nokea
Medication bound to protein can have which of the following effects?
- A. enhancement of drug availability
- B. rapid distribution of the drug to receptor sites
- C. less availability to produce desired medicinal effects
- D. increased metabolism of the drug by the liver
Correct Answer: C
Rationale: Protein-bound drugs are inactive and less available for therapeutic effects until unbound. This does not enhance availability, speed distribution, or increase metabolism.
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The nurse is caring for a postpartum woman who has relinquished her baby for adoption. The care plan for the client should include which of the following priority strategies?
- A. Make a referral for grief counseling
- B. Allow the woman to see her baby initially, and then discourage further visits
- C. Provide opportunities for the woman to express her feelings
- D. Inform the woman she has the right to change her mind about relinquishment
Correct Answer: C
Rationale: Providing opportunities to express feelings addresses the immediate emotional needs of grief, loneliness, and guilt, which is a priority for supporting the woman's psychological well-being.
A client needs to rapidly achieve a therapeutic plasma drug concentration of a medication. Rather than wait for steady state to be achieved, the physician might order:
- A. a maintenance dose.
- B. a loading dose.
- C. a medication with no first-pass effect.
- D. the medication to be given intravenously.
Correct Answer: B
Rationale: A loading or priming dose rapidly establishes a therapeutic plasma drug level. It can be calculated by multiplying the volume of distribution by the desired plasma drug concentration.
A client's central venous access device (CVAD) becomes infected. Why might the physician order antibiotics to be given through the line rather than through a peripheral IV line?
- A. to prevent infiltration of the peripheral line
- B. to reduce the pain and discomfort associated with antibiotic administration in a small vein
- C. to lessen the chance of an allergic reaction to the antibiotic
- D. to attempt to eliminate microorganisms in the catheter and prevent having to remove it
Correct Answer: D
Rationale: Microorganisms that infect CVADs are often coagulase-negative staphylococci, which can be eliminated by antibiotic administration through the catheter. If unsuccessful in eliminating the microorganism, the CVAD must be removed. CVAD use lessens the need for peripheral IV lines and thus the risk of infiltration. In this case, however, the antibiotics are given to eradicate microorganisms from the CVAD. CVAD use has the effect described in Choice 2, but in this case, the antibiotics are given through the CVAD to eliminate the infective agent. The route does not prevent an allergic reaction.
A day care center has asked the nurse to provide education for parents regarding safety in the home. What type of preventive care does this represent?
- A. primary
- B. secondary
- C. tertiary
- D. health promotion
Correct Answer: A
Rationale: Primary prevention involves activities that are utilized to promote wellness or prevent illness or injury. There are many dangers in the home for small children. Providing education regarding the need for safety measures to prevent injury in the home is considered primary prevention. Secondary prevention involves early detection of a disease or illness and quick intervention to aid the client in maintenance of the disease or injury. Tertiary prevention involves the reduction of a disability and the promotion of the highest level of functioning for a client in relation to his or her disease or injury. Health promotion is any activity that increases a client's health and wellness.
Which of the following vaccines is a live virus?
- A. varicella
- B. IPV
- C. DTaP
- D. hepatitis B
Correct Answer: A
Rationale: Varicella is a live virus, as is OPV. IPV is an inactivated polio vaccine.