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Over-the-counter drugs that may cause adverse effects include:
- A. Acetaminophen
- B. Aspirin
- C. Ibuprofen
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because acetaminophen (liver risk), aspirin (GI bleeding), and ibuprofen (ulcers, kidney issues) can all cause ADRs if misused, per safety data. Choice A is incorrect alone as it's one risk. Choice B is wrong by itself because aspirin is just part. Choice C is incorrect solo since ibuprofen is only one concern.
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A client has a new prescription for alendronate. Which of the following instructions should the nurse include?
- A. Take the medication with a full glass of water.
- B. Lie down for 30 minutes after taking the medication.
- C. Take the medication at bedtime.
- D. Avoid dairy products while taking the medication.
Correct Answer: A
Rationale: When taking alendronate, it is important to take the medication with a full glass of water to prevent esophageal irritation. This helps ensure that the medication reaches the stomach and is properly absorbed. Lying down after taking alendronate can increase the risk of esophageal irritation, which is why it is recommended to stay upright for at least 30 minutes after taking the medication. Taking the medication at bedtime or avoiding dairy products are not specific instructions associated with alendronate administration. Therefore, the correct instruction to include is to take the medication with a full glass of water.
An NP prescribes an oral elixir medication for a child who is to take 1 tsp PO bid. When counseling the child's parents about administering this drug, the NP should tell them to:
- A. shake the medication well before giving each dose.
- B. mix the medication with cereal or applesauce to improve its taste.
- C. administer the medication on an empty stomach to enhance absorption.
- D. use a syringe purchased at the pharmacy to measure the medication accurately.
Correct Answer: D
Rationale: The correct answer is D because a syringe ensures accurate dosing (teaspoons vary 2.5-7.8 mL). Choice A is incorrect (elixirs don’t need shaking). Choice B is wrong (mixing risks incomplete dosing). Choice C is inaccurate (empty stomach isn’t required).
Drugs that require therapeutic drug monitoring include:
- A. Lithium
- B. Acetaminophen
- C. Albuterol
- D. All of the above
Correct Answer: A
Rationale: Choice A is correct because lithium has a narrow therapeutic range, necessitating monitoring to maintain efficacy for bipolar disorder while avoiding toxicity, unlike the others. Choice B is incorrect as acetaminophen, used for pain, has a wider safety margin and doesn't require routine monitoring. Choice C is wrong because albuterol, a bronchodilator, acts locally with minimal systemic levels needing checks. Choice D is incorrect since only lithium among these requires therapeutic drug monitoring.
A woman who takes an angiotensin converting enzyme inhibitor for hypertension tells her primary care NP that she is trying to get pregnant. The NP should:
- A. consider replacing her angiotensin converting enzyme inhibitor with methyldopa.
- B. lower her angiotensin converting enzyme inhibitor dose during the first trimester.
- C. counsel her to increase her antihypertensive medications during pregnancy.
- D. add an angiotensin receptor blocker (ARB) during the first trimester of her pregnancy.
Correct Answer: A
Rationale: The correct answer is A because ACE inhibitors are contraindicated in pregnancy and should be replaced with safer options like methyldopa. Choice B is incorrect (lowering dose still risky). Choice C is wrong (increasing not indicated). Choice D is inaccurate (ARBs also contraindicated).
Signs that a drug may be counterfeit include:
- A. Unusual packaging
- B. Lower than expected cost
- C. Different taste or texture
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because unusual packaging (e.g., misspellings), suspiciously low cost (too good to be true), and odd taste/texture (formulation issues) are all counterfeit indicators, per FDA warnings. Choice A is incorrect alone as it's one sign. Choice B is wrong by itself because cost is just part. Choice C is incorrect solo since taste/texture is only one clue.