Nokea
Patients should be warned about the overuse of topical wintergreen oil to treat muscle strains, as overapplication can lead to:
- A. Respiratory depression
- B. Cardiac disturbance
- C. Salicylates poisoning
- D. Life-threatening rashes
Correct Answer: C
Rationale: Wintergreen oil contains methyl salicylate, which can cause salicylate poisoning if overused.
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The volume of distribution (Vd) for a drug that is completely retained in the vascular compartment would be?
- A. High
- B. Low
- C. Unchanged
- D. Cannot be determined
Correct Answer: B
Rationale: A drug confined to the vascular compartment (e.g., plasma) has a low Vd, close to plasma volume (about 0.06 L/kg), indicating limited distribution.
A client is taking Humulin NPH insulin daily every morning. The nurse reinforces instructions for the client and tells the client that the most likely time for a hypoglycemic reaction to occur is:
- A. 2 to 4 hours after administration
- B. 4 to 12 hours after administration
- C. 16 to 18 hours after administration
- D. 18 to 24 hours after administration
Correct Answer: B
Rationale: Humulin NPH is an intermediate-acting insulin. The onset of action is 1.5 hours, it peaks in 4 to 12 hours, and its duration of action is 24 hours. Hypoglycemic reactions most likely occur during peak time.
The 'donut hole' in Medicare Part D:
- A. Will be totally eliminated with the federal health-care reform enacted in 2010
- B. Refers to the period of time when annual individual drug costs are between 250 and 2,250 per year and drug costs are covered 75%
- C. Refers to the period between when the annual individual drug costs are 2,970 and 4,750 and the patient pays 52.5% of the costs of brand name drugs (2013)
- D. Has no effect on whether patients continue to fill their prescriptions during the coverage gap
Correct Answer: C
Rationale: The donut hole (2013) is the coverage gap where patients pay more out-of-pocket.
In deciding which of multiple drugs used to use to treat a condition, the NP chooses Drug A because it:
- A. Has serious side effects and it is not being used for a life-threatening condition
- B. Will be taken twice daily and will be taken at home
- C. Is expensive, but covered by health insurance
- D. None of these are important in choosing a drug
Correct Answer: B
Rationale: Choosing a drug taken twice daily at home reflects practical considerations like adherence, outweighing side effects or cost alone . All factors matter (D is false).
Which statement(s) is/are true regarding the types of medication orders? (Select one that does not apply.)
- A. Stat orders are the same as single dose orders.
- B. Verbal orders should be used as much as possible.
- C. Renewal orders facilitate physician review before continuance of high risk medications.
- D. PRN medications will designate a mandatory number of times the medication is to be administered.
Correct Answer: C
Rationale: Standing orders state the frequency of medication dosages to be administered or indicate the time frame of administration. Renewal orders require the physician to review medications that have expired orders, as determined by facility policy. Renewal policies facilitate physician verification of the necessity to continue a medication beyond a usual time frame and help ensure patient safety. Single dose and stat orders are not the same. PRN medications are not ordered a mandatory number of times, although a maximum number might be specified. Verbal orders should be avoided whenever possible.