Nokea
Patients who are on chronic long-term proton pump inhibitor therapy require monitoring for:
- A. Iron deficiency anemia, vitamin B12 and calcium deficiency
- B. Folate and magnesium deficiency
- C. Elevated uric acid levels leading to gout
- D. Hypokalemia and hypocalcemia
Correct Answer: A
Rationale: PPIs impair absorption of iron, B12, and calcium long-term; magnesium is also a risk but less emphasized here.
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The nurse is reviewing the patient's admission medication orders. What order would the nurse to question?
- A. Digoxin .5 mg orally now give one dose only
- B. Lasix 20 mg. IV every 4 hours times 3
- C. Gentamicin 80 mg IV to infuse over 1 hour every 12 hours
- D. Acetaminophen 650 mg PO every 4 hours as needed for pain
Correct Answer: A
Rationale: Digoxin .5 mg (0.5 mg) is a high initial dose; typical is 0.125-0.25 mg, requiring clarification.
All are pro drugs except
- A. Sulindac
- B. Codeine
- C. Talampicillin
- D. Chlorpromazine
Correct Answer: D
Rationale: Chlorpromazine is active as is; others are prodrugs.
A nurse at a provider's office is preparing to administer RV, DTaP, Hib, PCV13, and IPV immunizations to a 4-month-old infant. Which of the following actions should the nurse plan to take?
- A. Administer IPV orally
- B. Administer subcutaneous injections in the anterolateral thigh.
- C. Administer IM injections in the deltoid muscle.
- D. Give the infant a phone during vaccine injections.
Correct Answer: B
Rationale: Subcutaneous injections in the thigh and pacifier use are appropriate for a 4-month-old; IPV is IM, not oral.
Prostaglandins play pathophysiological role in the following EXCEPT:
- A. Patency of ductus arteriosus
- B. Regulation of renal tubular salt absorption
- C. Ventricular remodelling after myocardial infarction
- D. Initiation of labour
Correct Answer: C
Rationale: Prostaglandins maintain ductus arteriosus patency, regulate renal salt absorption, and initiate labor, but ventricular remodeling post-myocardial infarction is primarily driven by other factors like cytokines and neurohormones.
Which of the following adverse effects may occur due to a dihydropyridine-type calcium channel blocker?
- A. Bradycardia
- B. Hepatic impairment
- C. Increased contractility
- D. Edema of the hands and feet
Correct Answer: D
Rationale: Dihydropyridines (e.g., amlodipine) cause peripheral edema due to vasodilation.