Nokea
Ray has been diagnosed with hypertension and an angiotensin-converting enzyme inhibitor is determined to be needed. Prior to prescribing this drug, the NP should assess for:
- A. Hypokalemia
- B. Impotence
- C. Decreased renal function
- D. Inability to concentrate
Correct Answer: C
Rationale: ACE inhibitors can worsen renal function, necessitating baseline assessment.
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A primary health care provider instructs a nurse to administer a medication to a patient STAT. Which action by the nurse would be most appropriate?
- A. Insist on obtaining a written report before administering any drug.
- B. Administer the drug as ordered by the physician.
- C. Forgo obtaining the physician's order after the drug has been administered.
- D. Document the administration of the drug only after receiving the physician's order.
Correct Answer: B
Rationale: The nurse should administer the drug as instructed without a written order as it is an emergency. The nurse should, however, ensure that the physician's order is obtained after the drug has been administered. Waiting for a written order during an emergency may exacerbate the patient's condition. The nurse should complete the documentation immediately after the administration of the drug and not wait until the physician's order is received.
The patient tells the nurse about a new drug being tested to treat the disease she was diagnosed with and asks the nurse whether the doctor can prescribe a medication still in the preclinical phase of testing. What is the nurse's best response?
- A. The doctor would have to complete a great deal of paperwork to get approval to prescribe that drug.
- B. Sometimes pharmaceutical companies are looking for volunteers to test a new drug and the doctor could give them your name.
- C. Drugs in the preclinical phase of testing are only tested on animals and so would not be available to you.
- D. Drugs in the preclinical phase of testing are given only to healthy young men and so would not be available to you.
Correct Answer: C
Rationale: During the preclinical phase of testing drugs are tested on animals and are not available to patients. In phase I, the drug is tested on volunteers who are usually healthy young men. It is only in phase III studies that the drug is made available to prescribers who agree to closely monitor patients getting the medication.
Avoid concurrent administration of exenatide with which of the following drugs?
- A. Digoxin
- B. Warfarin
- C. Lovastatin
- D. All of the above
Correct Answer: D
Rationale: Exenatide delays gastric emptying, potentially affecting absorption of digoxin , warfarin , and lovastatin .
A nurse is administering digoxin to a patient. To administer medications so that the drug is as effective as possible, the nurse needs to consider what?
- A. Pharmacotherapeutics
- B. Pharmacokinetics
- C. Pharmacoeconomics
- D. Pharmacogenomics
Correct Answer: B
Rationale: When administering a drug, the nurse needs to consider the phases of pharmacokinetics so that the drug regimen can be made as effective as possible. Pharmacogenomics is the area of study that includes mapping of the human genome. Pharmacotherapeutics is the branch of pharmacology that deals with the uses of drugs to treat, prevent, and diagnose disease. Pharmacoeconomics includes all costs involved in drug therapy.
Children who should receive meningococcal conjugate vaccine (Hib-MenCY, MenHibrix) include:
- A. Children traveling to the Haj
- B. Infants, routinely at 2, 4, 6, and 12 to 15 months
- C. Infants with functional asplenia (including sickle cell disease)
- D. Two-year olds with complement deficiencies
Correct Answer: C
Rationale: Hib-MenCY is indicated for infants with asplenia (e.g., sickle cell); Haj travel applies to older meningococcal vaccines.