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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 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 nurse is caring for a client who has Depression and a new prescription for Venlafaxine. For which of the following adverse effects should the nurse monitor this client? (Select all that apply)
- A. Cough
- B. Dizziness
- C. Increased libido
- D. Invention
Correct Answer: B
Rationale: Venlafaxine can cause dizziness , decreased libido , and hypotension ; 'invention' seems a typo.
A nurse has administered an opioid drug to a patient. Which action would be most appropriate for the nurse to do immediately after administering the drug?
- A. Monitoring the vital signs of the patient
- B. Documenting administration of the drug
- C. Informing the patient about the type of drug
- D. Updating the physician regarding the patient's condition
Correct Answer: B
Rationale: After administration of any drug, the nurse should immediately document the administration. After the documentation is complete, the nurse can record the patient's vital signs. The patient needs to be informed about the drug before the administration. The physician need not be immediately informed, unless the client develops severe adverse reactions.
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.
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.