Nokea
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.
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The nursing assessment identifies that the client is nauseated and cannot take acetaminophen (Tylenol) orally. Which is true regarding the substitution of this medication to suppository form?
- A. It is standard practice when the patient is unable to take the ordered medication.
- B. It is acceptable if the patient agrees to the altered route form.
- C. It is preferable to having the patient miss a dose of the medication.
- D. It is contraindicated without an order from the health care provider.
Correct Answer: D
Rationale: One dosage form of medication should never be substituted for another unless the prescriber is consulted; there can be a great variation in the absorption rate of the medication through different routes of administration. The substitution of one form for another is not standard practice, and is not acceptable or preferable without the prescriber's order.
Patients who are being treated with epoetin alfa need to be monitored for the development of:
- A. Thrombocytopenia
- B. Neutropenia
- C. Hypertension
- D. Gout
Correct Answer: C
Rationale: Epoetin alfa can cause hypertension by increasing red cell mass; blood count issues or gout are less common.
The nursing instructor is discussing drug therapy in the older adult. What would the instructor tell the students about what could affect therapeutic dosing in an older adult?
- A. Changes in the gastrointestinal (GI) system can reduce drug absorption.
- B. In older adults, drugs enter into circulation more quickly.
- C. In older adults, drugs are distributed to a smaller portion of the tissues.
- D. In older adults, drugs have an increased action
Correct Answer: A
Rationale: GI changes in aging (e.g., reduced motility) decrease absorption, affecting dosing.
A 73-year-old male patient is being discharged home today. The discharge order reads: Take 10 mL of guaifenesin (Robitussin) with plastic measuring caps. How much should the nurse teach the client to take at home?
- A. 1/2 tsp
- B. 1 tsp
- C. 2 tsp
- D. 1 tbsp
Correct Answer: C
Rationale: 10 mL equals 2 teaspoons (1 tsp = 5 mL), the correct household measure for patient teaching.
Which of the following is an advantage of sublingual administration?
- A. Rapid absorption
- B. Convenient
- C. Avoid harsh GI environment
- D. Avoid first pass-metabolism
Correct Answer: D
Rationale: Sublingual administration offers rapid absorption , convenience , avoids the GI tract , and bypasses first-pass metabolism ; all are true, but D is a key pharmacological advantage.