Nokea
Narrow therapeutic index medications:
- A. are drug formulations with limited pharmacokinetic variability.
- B. have limited value and require no monitoring of blood levels.
- C. have less than a twofold difference in minimum toxic levels and minimum effective concentration in the blood
- D. have limited potency and side effects.
Correct Answer: C
Rationale: The therapeutic index is the ratio between the median lethal dose and median effective dose of a drug, indicating the safety margin. Narrow therapeutic index medications have a small difference between minimum toxic levels and minimum effective concentration in the blood, making them high-risk drugs that require close monitoring to avoid toxicity. Choice A is incorrect because pharmacokinetics refer to drug absorption, distribution, metabolism, and elimination, not the therapeutic index. Choice B is incorrect because narrow therapeutic index drugs necessitate monitoring due to their narrow margin of safety. Choice D is incorrect because narrow therapeutic index drugs do not necessarily have limited potency but are characterized by a small window between efficacy and toxicity.
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While the client is receiving quinidine, the nurse should monitor the ECG for:
- A. Peaked P wave
- B. Elevated ST segment
- C. Inverted T wave
- D. Prolonged QT interval
Correct Answer: D
Rationale: Quinidine can cause widened Q-T intervals and heart block, leading to a prolonged QT interval on the ECG. Other signs of myocardial toxicity associated with quinidine include notched P waves and widened QRS complexes. Common side effects of quinidine include diarrhea, nausea, and vomiting, while less common effects may include tinnitus, vertigo, headache, visual disturbances, and confusion. Monitoring for a prolonged QT interval is crucial due to the potential risk of serious arrhythmias. Choices A, B, and C are not typically associated with the use of quinidine and are therefore incorrect in this context.
A client in the cardiac step-down unit requires suctioning for excess mucous secretions. The nurse should be most careful to monitor the client for which dysrhythmia during this procedure?
- A. Bradycardia
- B. Tachycardia
- C. Premature ventricular beats
- D. Heart block
Correct Answer: A
Rationale: During suctioning, a vagal response can be triggered leading to bradycardia. It is crucial for the nurse to monitor for this potential dysrhythmia. Tachycardia (Choice B) is less likely during suctioning and is not the priority. Premature ventricular beats (Choice C) and heart block (Choice D) can occur but are less common compared to bradycardia in this situation.
When caring for African-American clients, what is an important consideration regarding their needs?
- A. Families may have specific needs.
- B. Special hair, skin, and nail care might be required.
- C. Cultural diets should be respected.
- D. Clients are generally future-oriented.
Correct Answer: B
Rationale: Correct answer: Special hair, skin, and nail care might be required. African-American clients may have specific hair, skin, and nail care needs due to their unique characteristics such as curly hair and melanin-rich skin. It is important for healthcare providers to be knowledgeable about these needs to provide appropriate care. Option A is incorrect as it does not address the specific care aspect related to the clients themselves. Option C is incorrect as assuming all African-American clients follow cultural diets is a stereotype and may not apply to every individual. Option D is incorrect as being future-oriented is not a characteristic that is universally applicable to African-American clients and does not directly impact nursing care considerations.
The nurse is caring for a client with a malignancy. The classification of the primary tumor is Tis. The nurse should plan care for a tumor:
- A. That can be assessed
- B. That is in situ
- C. With increasing lymph node involvement
- D. With distant metastasis
Correct Answer: B
Rationale: The correct answer is B: 'That is in situ.' Cancer in situ means that the cancer is still localized to the primary site. Cancer is graded in terms of tumor, grade, node involvement, and metastasis. Answer A is incorrect because Tis indicates a tumor that is in situ and can be assessed. Answer C is incorrect because T indicates tumor, not node involvement. Answer D is incorrect because a tumor that is in situ is not metastasized.
When assessing a client's self-expectations about weight loss, which question is most appropriate?
- A. "What makes you think you can change your eating habits?"?
- B. "How do you feel about losing weight?"?
- C. "How important is it that you lose weight?"?
- D. "What do you think is a realistic weekly weight loss for you?"?
Correct Answer: D
Rationale: When assessing a client's self-expectations about weight loss, it is crucial to inquire about what the client considers a realistic weekly weight loss goal. This question helps in understanding the client's perception and expectations regarding the weight loss journey, enabling the establishment of achievable goals. Choices A, B, and C do not directly address the aspect of setting realistic goals for weight loss. While questioning about changing eating habits, feelings about losing weight, or the importance of weight loss are relevant, they do not specifically focus on setting achievable goals, which is essential for effective weight management.