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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Drug which crosses the placental barrier is:
- A. Phenytoin
- B. Diazepam
- C. Corticosterioids
- D. All of the above
Correct Answer: D
Rationale: All listed drugs cross the placenta, affecting the fetus.
When patients are started on darbepoetin alfa (Aranesp) they need monitoring of their blood counts to determine a dosage adjustment in:
- A. 6 weeks if they are a cancer patient
- B. 1 week if they have chronic renal failure
- C. 2 weeks if they are taking it for allogenic transfusion
- D. Each week throughout therapy
Correct Answer: A
Rationale: Cancer patients need blood count checks at 6 weeks for darbepoetin adjustment; renal patients adjust sooner, typically 2-4 weeks.
Which of the following is the mechanism of action of iodides:
- A. Inhibits organification of iodine
- B. By inhibiting \mathrm{Na}+/ \mathrm{l} - simporter reduce iodine transport in thyroid gland
- C. Inhibits production of trioodthyronine form tetraiodthyronine on periphery
- D. Stimulates peroxidase
Correct Answer: A
Rationale: Iodides inhibit iodine organification, reducing thyroid hormone synthesis in high doses.
An older adult experiencing shortness of breath is brought to the hospital by her daughter. While obtaining the medication history from the patient and her daughter, the nurse discovers that neither has a list of the patient's current medications or prescriptions. The patient has a weekly pill dispenser that contains four different pills. The prescriptions are filled through the local pharmacy. Which resource would be appropriate to use in determining the medication names and doses?
- A. Martindale-The Complete Drug Reference
- B. Drugs and Facts Comparisons
- C. Senior citizens' center
- D. Patient's home pharmacy
Correct Answer: D
Rationale: The patient's pharmacy maintains an accurate record of all current medications, making it the best resource for identifying the drugs and doses.
Discharge planning for patients leaving the hospital should include instructions on the use of over-the-counter (OTC) drugs. Which comment by the patient would demonstrate a good understanding of OTC drugs?
- A. OTC drugs are always safe and will not cause bad effects.'
- B. OTC drugs have been around for years and have not been tested by the Food and Drug Administration (FDA).'
- C. OTC drugs are different from any drugs available by prescription and cost less.'
- D. OTC drugs are thought to be safe when taken as directed.'
Correct Answer: D
Rationale: OTC drugs are drugs that have been determined to be safe when taken as directed. They may have originally been prescription drugs that were tested by the FDA or they may have been grandfathered in when the FDA laws changed. OTC education should always be included as a part of the hospital discharge instructions.