Nokea
Richard is 70 years old and has a history of cardiac dysrhythmias. He has been prescribed nadolol. You do his annual laboratory work and find a CrCl of 25 ml/min. What action should you take related to his nadolol?
- A. Extend the dosage interval.
- B. Decrease the dose by 75%.
- C. Take no action because this value is expected in the older adult.
- D. Schedule a serum creatinine level to validate the CrCl value.
Correct Answer: A
Rationale: Reduced renal clearance (CrCl 25 ml/min) requires extending the dosage interval for nadolol.
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Student nurses are learning to weigh patients and do vital signs. How does a correct weight impact administering medication?
- A. Proper dosage calculation
- B. Assessing changes in fluid balance
- C. Assessing changes in nutritional status
- D. Caloric needs
Correct Answer: A
Rationale: Accurate weight is essential for calculating correct medication dosages, especially for weight-based drugs.
The nurse is assessing a diabetic patient who has presented at the clinic reporting several hypoglycemic episodes during the past 3 weeks. The nurse questions the patient about the use of herbal or alternative therapies, suspecting what herbal remedy could cause the hypoglycemic episodes?
- A. St. John's wort
- B. Kava
- C. Fish oil
- D. Ginseng
Correct Answer: D
Rationale: Ginseng is known to decrease blood sugar levels. If the patient used this in combination with his or her oral antidiabetic agent, diet, and exercise, his or her blood sugar could drop below therapeutic levels. St. John's wort interacts with many drugs, but not with antidiabetic agents. Kava is associated with liver toxicity. Fish oil has been associated with decreased coronary artery disease.
Pharmacokinetic factors that affect prescribing include:
- A. Therapeutic index
- B. Minimum effective concentration
- C. Bioavailability
- D. Ease of titration
Correct Answer: C
Rationale: Bioavailability directly impacts how much drug reaches circulation, a key pharmacokinetic factor, unlike therapeutic index or titration ease .
A nurse is preparing a presentation for a group of nurses about actions that nurses can do to help prevent drug errors. Which of the following would the nurse include? Select one that does not apply
- A. Rechecking all calculations
- B. Always administering the drug before answering any of the client's questions
- C. Avoiding distractions and concentrating on only one task at a time
- D. Confirming any questionable orders
Correct Answer: B
Rationale: In addition to following the five +1 rights of drug administration, a nurse can employ the following strategies to aid in the prevention of drug errors: confirm any questionable orders; when calculations are necessary, verify them with another nurse; listen to the client when he or she questions a drug, the dosage, or the drug regimen; never administer the drug until the client's questions have been adequately researched; and avoid distractions and concentrate on only one task at a time.
According to the 2003-2006 National Health and Nutrition Examination Survey study of dietary intake, the group at highest risk for inadequate calcium intake was:
- A. The elderly (over age 60 years)
- B. Teenage females
- C. Teenage males
- D. Preschoolers
Correct Answer: B
Rationale: Teenage females are at high risk for inadequate calcium intake due to dietary habits and growth demands.