Nokea
Patients who are being treated with epoetin alfa need to be monitored for the development of:
- A. Thrombocytopenia
- B. Neutropenia
- C. Hypertension
- D. Gout
Correct Answer: C
Rationale: Epoetin alfa can cause hypertension by increasing red cell mass; blood count issues or gout are less common.
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Behaviors predictive of addiction to controlled substances include:
- A. Stealing or borrowing another patient's drugs
- B. Requiring increasing doses of opiates for pain associated with malignancy
- C. Receiving refills of a Schedule II prescription on a regular basis
- D. Requesting that only their own primary care provider prescribe for them
Correct Answer: A
Rationale: Stealing/borrowing drugs strongly predicts addiction, unlike cancer-related dose increases or regular refills/provider preference , which may be legitimate.
A nurse orienting a newly licensed nurse is reviewing the procedure for taking a telephone prescription. Which of the following statements should the nurse identify as an indication that the newly licensed nurse understands the process?
- A. A second nurse enters the prescription into the client's medical record.
- B. Another nurse should listen to the phone call:
- C. The provider can clarify the prescription when he signs the health record.
- D. I should omit the 'read back' if this is a one-time prescription
Correct Answer: B
Rationale: Having another nurse listen ensures accuracy in transcribing verbal orders, a standard safety protocol.
A 20-year-old boy suffered from a moderate aspirin toxicity he may be managed by promoting its renal excretion when infused with:
- A. Ascorbid acid
- B. Ammonium chloride
- C. Arginine chloride
- D. Sodium bicarbonate
Correct Answer: D
Rationale: Sodium bicarbonate alkalinizes urine, enhancing aspirin (a weak acid) excretion.
Which of the following best describes the effect of propylthiouracil on thyroid hormone production?
- A. It blocks the release of thyrotropin-releasing hormone
- B. It inhibits uptake of iodide by thyroid cells
- C. It prevents the release of thyroid hormone from thyroglobulin
- D. It blocks iodination and coupling of tyrosines in thyroglobulin to form thyroid hormones
Correct Answer: D
Rationale: Propylthiouracil blocks iodination and coupling in thyroglobulin, inhibiting thyroid hormone synthesis.
Which drug has a high first pass effect
- A. Amiodarone
- B. Phenytoin
- C. Verapamil
- D. Disopyramide
Correct Answer: C
Rationale: Verapamil undergoes extensive first-pass metabolism in the liver, reducing its bioavailability when taken orally.