Nokea
Patients taking warfarin need to be educated about the vitamin K content of foods to avoid therapeutic failure. Foods high in vitamin K that should be limited to no more than one serving per day include:
- A. Spinach
- B. Milk
- C. Romaine lettuce
- D. Cauliflower
Correct Answer: A
Rationale: Spinach is high in vitamin K, which can antagonize warfarin's anticoagulant effect if consumed excessively.
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Patients with pheochromocytoma should avoid which of the following classes of drugs because of the possibility of developing hypertensive crisis?
- A. Expectorants
- B. Beta-2-agonists
- C. Antitussives
- D. Antihistamines
Correct Answer: B
Rationale: Beta-2-agonists can stimulate catecholamine release in pheochromocytoma, risking hypertensive crisis; other classes are safer.
A nurse is caring for a client after thyroidectomy and notes that calcium gluconate is prescribed for the client. The nurse determines that this medication has been prescribed to:
- A. Treat thyroid storm.
- B. Prevent cardiac irritability.
- C. Treat hypocalcemic tetany.
- D. Stimulate the release of parathyroid hormone.
Correct Answer: C
Rationale: Hypocalcemia can develop after thyroidectomy if the parathyroid glands are accidentally removed or injured during surgery. Manifestations develop 1 to 7 days after surgery. If the client develops numbness and tingling around the mouth, fingertips, or toes or muscle spasms or twitching, the health care provider is notified immediately. Calcium gluconate should be kept at the bedside.
A 52-year-old overweight woman presents to the clinic for a diabetes management. She had not been doing well controlling her blood sugars with metformin. Her last hemoglobin A1c was 13.4%, despite her taking her medication every day. The physician decides to start her on a long-acting insulin that is injected only once a day for better glucose control. Also, he wants the insulin to have a minimal risk of hypoglycemia. What is the most likely medication given to this patient?
- A. Insulin aspart
- B. Insulin glargine
- C. Insulin lispro
- D. NPH insulin
Correct Answer: B
Rationale: Insulin glargine is a long-acting, peakless insulin administered once daily, with a lower risk of hypoglycemia compared to other insulins.
The patient asks the nurse why generic drugs would be used and voices concerns that only the brand name product will be safe. What is the nurses best response?
- A. Generic drugs are often less expensive.
- B. Some quality control problems have been found with generic drugs.
- C. Most generic drugs are very safe and can be cost effective as well.
- D. Although initial cost is higher for a brand name it may cost less in the long run.
Correct Answer: C
Rationale: Most generic medications are completely safe and may be identical to the brand name drug except generic medications are often less expensive, but this does not address the patients concern about safety. Although some quality control issues have occurred in the past, this does not address the patients concerns regarding safety or explain why generic drugs are prescribed and used. Although some doctors believe initial cost is higher but will cost less over time, this response also does not address the patients concerns.
Which of the following is a disadvantage of IM administration?
- A. Larger volumes can be used
- B. Can affect lab tests
- C. Painful
- D. B and C
Correct Answer: C
Rationale: Intramuscular (IM) administration is painful due to needle insertion, though larger volumes are an advantage; affecting lab tests is less specific, making C the primary disadvantage.