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Pharmaceutical promotion may affect prescribing. To address the impact of pharmaceutical promotion, the Institute of Medicine has made by the following recommendations:
- A. Conflicts of interest and financial relationships should be disclosed by those providing education.
- B. Providers should ban all pharmaceutical representatives from their office setting.
- C. Drug samples should be used for patients who have the insurance to pay for them, to ensure the patient can afford the medication.
- D. Providers should only accept low-value gifts, such as pens and pads of paper, from the pharmaceutical representative.
Correct Answer: A
Rationale: Disclosing conflicts promotes transparency, per IOM, unlike banning reps , limiting samples by insurance , or allowing low-value gifts .
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Patients should be instructed regarding the rapid onset of zolpidem (Ambien) because:
- A. Zolpidem should be taken just before going to bed.
- B. Zolpidem may cause dry mouth and constipation.
- C. Patients may need to double the dose for effectiveness.
- D. They should stop drinking alcohol at least 30 minutes before taking zolpidem.
Correct Answer: A
Rationale: Zolpidem's rapid onset requires bedtime administration to prevent falls or amnesia.
A 22-year-old patient calls the clinic and tells the nurse that she has been depressed and is thinking about taking St. John's wort but wants to know if it is safe first. The nurse begins by questioning what other medications the patient takes and would be concerned about a drug-alternative drug interaction if the patient is also taking what type of medication?
- A. Antihistamines
- B. Analgesics
- C. Antibiotics
- D. Oral contraceptives
Correct Answer: D
Rationale: St. John's wort can interact with oral contraceptives that alter drug metabolism, which can decrease the effectiveness of the contraceptive. Analgesics, antibiotics, and antihistamines can be taken in combination with St. John's wort without known adverse effects.
A nurse is teaching a client who has a new prescription for Dextromethorphan to suppress a cough. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?
- A. Diarrhea
- B. Anxiety
- C. Sedation
- D. Palpitations
Correct Answer: C
Rationale: Dextromethorphan can cause sedation , a common side effect of this cough suppressant.
A patient who has oral candidiasis will begin using nystatin suspension to treat the infection. What information will the nurse include when teaching this patient?
- A. Coat the buccal mucosa with the drug and then rinse your mouth
- B. Gargle with the nystatin and then spit it out without swallowing
- C. Mix the suspension with 4 ounces of water and then drink it
- D. Swish the liquid in your mouth and then swallow after a few minutes
Correct Answer: D
Rationale: Nystatin should coat the mouth and be swallowed for oral candidiasis; spitting or rinsing reduces efficacy. Patients should be taught to swish the suspension in the mouth to coat the tongue and buccal mucosa and then swallow the medication.
The FDA established a safety information and adverse events reporting program called MedWatch. Which individuals can access the MedWatch website to obtain safety alerts on drugs, devices, or dietary supplements?
- A. Physicians
- B. Nurses
- C. Patients
- D. All of the above
Correct Answer: D
Rationale: Anyone can access the MedWatch website to obtain safety alerts on drugs, devices, or dietary supplements.