Nokea
Michael calls the clinic to ask about taking fish oil supplements with his simvastatin prescription. The NP's response is:
- A. Avoid fish oil as it will increase your risk of bleeding.
- B. There are no known interactions; it is safe to take fish oil with simvastatin.
- C. Avoid fish oil as it will decrease the effectiveness of the simvastatin.
- D. Fish oil should only be taken with simvastatin if prescribed by your cardiologist.
Correct Answer: B
Rationale: Choice B is correct because fish oil (omega-3s) and simvastatin both lower triglycerides with no significant interactions; studies show they're safe together, enhancing lipid benefits. Choice A is incorrect as fish oil's bleeding risk is minimal and not amplified by simvastatin. Choice C is wrong because fish oil doesn't reduce simvastatin's efficacy—they're complementary. Choice D is incorrect since no prescription is needed for this safe combination.
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The client is being taught about the use of sublingual nitroglycerin for chest pain. Which instruction should be provided?
- A. Swallow the tablet whole with water.
- B. Place the tablet under the tongue and let it dissolve.
- C. Chew the tablet and then swallow.
- D. Place the tablet between the cheek and gum.
Correct Answer: B
Rationale: The correct method for administering sublingual nitroglycerin is to place the tablet under the tongue and allow it to dissolve. This route of administration facilitates rapid absorption of the medication into the bloodstream, enabling quick relief of chest pain associated with angina or heart conditions. Choice A is incorrect because sublingual nitroglycerin should not be swallowed whole. Choice C is wrong as chewing the tablet can lead to the rapid release of the drug, causing adverse effects like headaches or dizziness. Choice D is also incorrect as the tablet should not be placed between the cheek and gum, but under the tongue for proper absorption.
VKORC1 genetic variations would affect which drug?
- A. Warfarin
- B. Codeine
- C. Acetaminophen
- D. All of the above
Correct Answer: A
Rationale: Choice A is correct because VKORC1 variants alter warfarin's target enzyme, affecting its anticoagulant effect and requiring dose adjustments. Choice B is incorrect as codeine's action is CYP2D6-mediated, not VKORC1-related. Choice C is wrong because acetaminophen doesn't interact with VKORC1—it's unrelated to coagulation. Choice D is incorrect since only warfarin is impacted by VKORC1 genetics.
While assessing a client taking propranolol, which finding should the nurse report to the provider?
- A. Bradycardia
- B. Dry mouth
- C. Constipation
- D. Increased appetite
Correct Answer: A
Rationale: Bradycardia is a significant side effect of propranolol, a beta-blocker that slows the heart rate. It indicates potential cardiovascular complications and should be reported promptly to the healthcare provider for further evaluation and management. Dry mouth, constipation, and increased appetite are common side effects of various medications but are not directly associated with propranolol's mechanism of action.
Risk factors for drug abuse include:
- A. Family history of addiction
- B. Mental health disorders
- C. Peer pressure
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because family history (genetic predisposition), mental health issues (self-medication), and peer pressure (social influence) are all established risk factors, per SAMHSA. Choice A is incorrect alone as it's one factor. Choice B is wrong by itself because mental health is just part. Choice C is incorrect solo since pressure is only one element.
Strategies to monitor controlled substance use include:
- A. Prescription drug monitoring programs
- B. Patient education
- C. Urine drug screening
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because PDMPs track prescriptions, education informs risks, and urine screening detects misuse—all key monitoring tools per guidelines. Choice A is incorrect alone as it's one method. Choice B is wrong by itself because education is just part. Choice C is incorrect solo since screening is only one approach.