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One major drug used to treat bipolar disease is lithium. Because lithium has a narrow therapeutic range, it is important to recognize symptoms of toxicity, such as:
- A. Orthostatic hypotension
- B. Agitation and irritability
- C. Drowsiness and nausea
- D. Painful urination and abdominal distention
Correct Answer: C
Rationale: Lithium toxicity commonly presents with drowsiness and nausea.
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A nurse is preparing to administer a prescribed medication to a client. The nurse integrates knowledge of which of the following as a possible factor that could influence the drug response?
- A. Age
- B. Polypharmacy
- C. Weight
- D. All the above
Correct Answer: D
Rationale: Drug response can be influenced by the following factors: age, polypharmacy, weight, sex, disease, and genetics.
A nurse is calculating a child's medication dose by using Clark's Rule. Which of the following calculations represents the application of Clark's Rule?
- A. Infant's age in months/150 months the average adult dose
- B. Child's age in years/child's age in years +12 times the average adult dose
- C. Weight of child in pounds/150 pounds the average adult dose
- D. Surface area in square meters/1.73 the average adult dose
Correct Answer: C
Rationale: Clark's Rule uses the child's weight to calculate the dose and assumes the adult dose is based on a 150-pound person. Fried's Rule applies to a child younger than 1 year of age and assumes that an adult dose would be appropriate for a child who is 12.5 years (150 months) old. Young's Rule applies to children 1 to 12 years of age. Surface area calculation of a child's dose is determined with the use of a nomogram including the child's height and weight.
During what phase of the nursing process would the nurse be required to consider the efficacy of nursing interventions related to drug therapy?
- A. Assessment
- B. Nursing diagnosis
- C. Interventions
- D. Evaluation
Correct Answer: D
Rationale: Evaluation assesses the effectiveness of interventions, including drug therapy outcomes, to determine if goals are met.
The use of information technology for quality improvement in pharmacotherapeutics includes:
- A. Incorporating the use of 'apps' into all patient encounters
- B. Tracking data trends within the practice via the electronic health record database
- C. Informing patients that they have access to their medication list via the Internet
- D. Using macros for individualizing patient care management
Correct Answer: B
Rationale: Tracking data trends in EHRs supports quality improvement in pharmacotherapeutics.
Up to 21% of Asians are ultra-rapid 2D6 metabolizers, requiring:
- A. A need to monitor drugs metabolized by 2D6 for toxicity
- B. Increased dosages needed of drugs metabolized by 2D6, such as the selective serotonin reuptake inhibitors
- C. Decreased conversion of codeine to morphine by CYP 2D6
- D. The need for lowered dosages of drugs, such as beta blockers
Correct Answer: B
Rationale: Ultra-rapid 2D6 metabolizers (e.g., in Asians) need higher SSRI doses due to fast metabolism, unlike toxicity , codeine issues , or lower doses .