Nokea
Patients with pernicious anemia require treatment with:
- A. Iron
- B. Folic acid
- C. Epogen alpha
- D. Vitamin B12
Correct Answer: D
Rationale: Pernicious anemia requires vitamin B12 due to absorption deficiency; folate masks it without correcting neuropathy.
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James is a 52-year-old overweight smoker taking theophylline for his persistent asthma. He tells his provider he is going to start the Atkin's diet for weight loss. The appropriate response would be:
- A. Congratulate him on making a positive change in his life
- B. Recommend he discuss this with his provider since the Atkin's diet increases the risk of theophylline toxicity
- C. Tell him the Atkin's diet has no effect on theophylline
- D. Suggest adding a steroid inhaler to manage asthma during the diet
Correct Answer: B
Rationale: The Atkin's diet (high-fat, low-carb) can increase theophylline levels, risking toxicity ; simple congratulations or dismissal overlook this interaction.
A nurse is preparing a teaching plan for a female client who has Bipolar disorder and a new prescription for Carbamazepine. Which of the following instructions should the nurse include in the teaching? (Select one that does not apply.)
- A. This medication can safely be taken during pregnancy.
- B. Eliminate grapefruit juice from your diet.
- C. You will need to have a complete blood count and carbamazepine levels drawn periodically.
- D. You'll your provider if you develop a rash.
Correct Answer: A
Rationale: Grapefruit juice interacts, blood counts monitor toxicity, rash signals reaction, and driving caution addresses sedation.
The adverse events of biguanides are:
- A. Alkalosis
- B. Hypoxemia/acidosis
- C. Weight loss
- D. Anemia
Correct Answer: B
Rationale: Biguanides like metformin can cause lactic acidosis, a serious adverse effect related to impaired mitochondrial function.
While collecting a medication history, the patient admits to doubling the recommended dosage of an over-the-counter (OTC) medication, saying its harmless or they would require a prescription. What is the nurses best response?
- A. OTC drugs are serious medications and carry serious risks if not taken as directed.
- B. Taking medications like that is careless and you could kill yourself doing it.
- C. Sometimes you need to take more than the package directs to treat the symptoms.
- D. Did you notify your doctor of the increased dosage you were taking?
Correct Answer: A
Rationale: OTC drugs are no less a medication than prescription drugs and carry the same types of risks for overdosage and toxicity if directions are not followed. Although increasing the dosage is careless and dangerous, it is important to use the information as a teaching opportunity rather than scolding the patient. Agreeing with the patient or asking her if she talked to the doctor misses the teaching opportunity, which could be harmful for the patient.
Which of the following vitamin or mineral supplements may by teratogenic if a pregnant woman takes more than the recommended amount?
- A. Iron
- B. Vitamin A
- C. Vitamin B6
- D. Vitamin C
Correct Answer: B
Rationale: Excess vitamin A (retinol) is teratogenic, potentially causing congenital malformations.