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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 client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication?
- A. Glucose level
- B. Calcium level
- C. Potassium level
- D. Prothrombin time
Correct Answer: B
Rationale: Tamoxifen may increase calcium, cholesterol, and triglyceride levels. Before the initiation of therapy, a complete blood count, platelet count, and serum calcium levels should be assessed. These blood levels, along with cholesterol and triglyceride levels, should be monitored periodically during therapy. The nurse should assess for hypercalcemia while the client is taking this medication. Signs of hypercalcemia include increased urine volume, excessive thirst, nausea, vomiting, constipation, hypotonicity of muscles, and deep bone and flank pain.
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.
According to traditional Chinese medicine, if a person who has a fever is given a herb that is yang in nature, such as golden seal, the patient's illness will:
- A. Get worse
- B. Get better
- C. Not be adequately treated
- D. Need additional herbs to treat the yang
Correct Answer: A
Rationale: A yang (warming) herb like golden seal would worsen a fever, a yang condition.
Antacids such as calcium carbonate (Tums) can reduce the absorption of which of the following nutrients?
- A. Protein
- B. Calcium
- C. Iron
- D. Vitamin K
Correct Answer: C
Rationale: Calcium carbonate binds to iron, forming insoluble complexes that reduce iron absorption.
Which of the following is thyroid hormone:
- A. Triiodthironine
- B. Monoiodthirozine
- C. Diiodthirozine
- D. Octaiodthironine
Correct Answer: A
Rationale: Triiodothyronine (T3) is a key thyroid hormone that regulates metabolism, unlike the others which are not primary hormones.