Nokea
Patrick is a 10-year-old patient who presents with uncomfortable constipation. Along with diet changes, a laxative is ordered to provide more rapid relief of constipation. An appropriate choice of medication for a 10-year-old child would be:
- A. PEG 3350 (Miralax)
- B. Bisacodyl (Dulcolax) suppository
- C. Docusate (Colace) suppository
- D. Polyethylene glycol electrolyte solution
Correct Answer: A
Rationale: PEG 3350 is safe and effective for kids; suppositories (B, C) are less preferred, and PEG solution is for bowel prep.
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Patients should be warned about the overuse of topical wintergreen oil to treat muscle strains, as overapplication can lead to:
- A. Respiratory depression
- B. Cardiac disturbance
- C. Salicylates poisoning
- D. Life-threatening rashes
Correct Answer: C
Rationale: Wintergreen oil contains methyl salicylate, which can cause salicylate poisoning if overused.
The 'donut hole' in Medicare Part D:
- A. Will be totally eliminated with the federal health-care reform enacted in 2010
- B. Refers to the period of time when annual individual drug costs are between 250 and 2,250 per year and drug costs are covered 75%
- C. Refers to the period between when the annual individual drug costs are 2,970 and 4,750 and the patient pays 52.5% of the costs of brand name drugs (2013)
- D. Has no effect on whether patients continue to fill their prescriptions during the coverage gap
Correct Answer: C
Rationale: The donut hole (2013) is the coverage gap where patients pay more out-of-pocket.
Characteristics of vitamin D and its metabolites include which of the following?
- A. Act to decrease serum levels of calcium
- B. Activation of vitamin D receptors in the major cells of
- C. Calcitriol is the major derivative responsible for increasing intestinal absorption of phosphate
- D. Metabolites of vitamin D increase renal excretion of calcium
Correct Answer: C
Rationale: Calcitriol increases intestinal absorption of calcium and phosphate.
The nurse is caring for a patient scheduled for surgery this morning who is not to be given anything orally. The nurse reviews the medication administration record and finds the patient has an important medication due but it is supposed to be given orally. What is the nurse's best action?
- A. Give the medication with a small sip of water.
- B. Give the medication via a different route.
- C. Hold the medication and put a note on the front of the chart for the surgeon.
- D. Call the ordering health care provider and clarify administration
Correct Answer: D
Rationale: NPO status requires physician clarification to ensure safety and appropriateness of administration.
Isoproterenol produces maximal contraction of cardiac muscle in a manner similar to epinephrine. Which of the following best describe isoproterenol?
- A. Fuller agonist
- B. Partial agonist
- C. Irreversible antagonist
- D. Inverse agonist
Correct Answer: A
Rationale: Isoproterenol's maximal effect similar to epinephrine indicates it is a full agonist at beta receptors.