Nokea
Renal damage is a potential adverse effect of aminoglycosides. In what part of the kidney are aminoglycosides retained which causes this effect?
- A. Distal tubule
- B. Proximal tubule
- C. Loop of Henle
- D. Glomerulus
Correct Answer: B
Rationale: Aminoglycosides are nephrotoxic and accumulate in the proximal tubule, leading to cellular damage and potential renal impairment.
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Besides cystic fibrosis, which other medical state may trigger the need for pancreatic enzymes?
- A. Paget's disease
- B. Pulmonary cancers
- C. Gallbladder surgery
- D. Some bariatric surgeries
Correct Answer: D
Rationale: Bariatric surgeries like gastric bypass can impair pancreatic function, necessitating enzymes; gallbladder doesn't typically.
A nurse is caring for a patient who has recently moved from Vermont to south Florida. The patient has been on the same antihypertensive drug for 6 years and has had stable blood pressures and no side effects. Since her move, however, she reports having 'dizzy spells and weakness' and feels that the drug is no longer effective. The nurse knows that one possible reason for the change in the effectiveness of the drug could be which of the following?
- A. The impact of the placebo effect on the patient's response
- B. The accumulative effect of the drug if it has been taken for many years
- C. The impact of the warmer environment on the patient's physical state
- D. Problems with patient compliance with the drug regimen while on vacation
Correct Answer: C
Rationale: Antihypertensive drugs work to decrease the blood pressure. When a patient goes to a climate that is much warmer than usual, blood vessels dilate and the blood pressure falls. If a patient is taking an antihypertensive drug and enters a warmer climate, there is a chance that the patient's blood pressure will drop too low, resulting in dizziness and feelings of weakness. Most antihypertensives are metabolized and excreted and do not accumulate in the body. Patients must be very compliant with their drug regimen while on vacation. After several years on an antihypertensive drug, the effects of that drug are known; therefore, the placebo effect should not be an issue.
What is the responsibility of the nurse related to the patient's drug therapy? (Select all that apply.)
- A. Teaching the patient how to cope with therapy to ensure the best outcome
- B. Providing therapy as well as medications
- C. Changing of therapy routines
- D. Altering the drug regimen to optimize outcome
Correct Answer: A
Rationale: Nurses teach patients, evaluate therapy effectiveness, but do not alter regimens (physician's role) or provide therapy beyond medication administration.
The nurse is preparing to administer a prescribed drug to a patient. The patient looks at the tablet and says, 'This doesn't look like my usual pill.' Which response by the nurse would be most appropriate?
- A. This is the same pill your doctor has been ordering.'
- B. It must be from a different manufacturer.'
- C. It looks different? Are you sure?'
- D. Let me double check with your doctor and the order.'
Correct Answer: D
Rationale: If the patient makes any statement about the drug, the nurse needs to hold the drug and investigate the patient's statement, double checking the chart and the order and obtaining clarification and/or confirmation from the prescriber. It may be that the dosage or manufacturer has changed and that is what makes the pill look different. It is always important to err on the side of caution. Telling the patient that the pill is the same or that it is from a different manufacturer may be true, but the nurse needs to confirm that before giving it to the patient. Repeating the patient's statement and then asking him if he is sure is inappropriate because it implies that the patient is incorrect.
Which of the following adverse effects may occur due to a dihydropyridine-type calcium channel blocker?
- A. Bradycardia
- B. Hepatic impairment
- C. Increased contractility
- D. Edema of the hands and feet
Correct Answer: D
Rationale: Dihydropyridines (e.g., amlodipine) cause peripheral edema due to vasodilation.