Nokea
Release of the mineralcorticoids is stimulated with:
- A. Low concentration of \mathrm{Na}+ in the blood
- B. Hypokalemia
- C. Low concentration of angiotensin II in the blood
- D. Low concentration of \mathrm{Mg} 2+ in the blood
Correct Answer: A
Rationale: Low blood sodium stimulates aldosterone release via the renin-angiotensin system.
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A 70-year-old patient has just received a drug, which can cause sedation. What would be the priority nursing diagnosis for this patient?
- A. Noncompliance: Cost of the drug
- B. Deficient knowledge: Unfamiliar with drug therapy
- C. Risk for injury: Related to adverse effects of the drug
- D. Ineffective health maintenance: Need for medication
Correct Answer: C
Rationale: Sedation increases the risk of falls or injury, making 'Risk for injury' the priority nursing diagnosis for a 70-year-old patient, given age-related vulnerabilities.
Factors that facilitate keeping patient information confidential in an electronic health record (EHR) system include:
- A. Designing software so that only those who need the information can gain access
- B. Requiring providers to log off at the end of the clinical day
- C. Keeping a file of the login and password information for each provider in a secure place
- D. Having patients sign informed consent documents to have their data on an EHR
Correct Answer: A
Rationale: Restricted access software enhances EHR confidentiality.
Drug errors are most likely to occur at which time? Select one that does not that apply.
- A. When transcribing the drug order
- B. When verifying the client
- C. When dispensing the drug
- D. When the drug is administered
Correct Answer: B
Rationale: Drug errors may occur in transcribing drug orders, when the drug is dispensed, or in administration of the drug. Nurses, as the drug administrators, serve as the last defense against drug errors. Verifying the client and charting after administration are two important areas to help prevent medication errors.
A nurse is caring for a patient who has been receiving a drug by the intramuscular route but will receive the drug orally after discharge. How does the nurse explain the increased dosage prescribed for the oral dose?
- A. Passive diffusion
- B. Active transport
- C. Glomerular filtration
- D. First-pass effect
Correct Answer: D
Rationale: The first-pass effect involves drugs that are absorbed from the small intestine directly into the portal venous system, which delivers the drug molecules to the liver. After reaching the liver, enzymes break the drug into metabolites, which may become active or may be deactivated and readily excreted from the body. A large percentage of the oral dose is usually destroyed and never reaches tissues. Oral dosages account for the phenomenon to ensure an appropriate amount of the drug in the body to produce a therapeutic action. Passive diffusion is the major process through which drugs are absorbed into the body. Active transport is a process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney. Glomerular filtration is the passage of water and water-soluble components from the plasma into the renal tubule.
Which of the following beta-blockers also has additional alpha-blocking activity?
- A. Nadolol
- B. Pindolol
- C. Labetalol
- D. Esmolol
Correct Answer: C
Rationale: Labetalol has both beta and alpha-1 blocking activity, making it unique among beta-blockers.