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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Which of the following drugs is used to accelerate pulmonary maturation in the fetus in women with premature labor?
- A. Aminoglutethimide
- B. Betamethasone
- C. Mifepristone
- D. Misoprostol
Correct Answer: B
Rationale: Betamethasone, a glucocorticoid, is administered to enhance fetal lung maturation by stimulating surfactant production in preterm labor.
You are assigned to infuse 300 mL of a solution over 2 hours with a drop factor of 15 gtt/mL. What is the flow rate in drops per minute?
- A. 25 gtt/min
- B. 37.5 gtt/min
- C. 45 gtt/min
- D. 75 gtt/min
Correct Answer: B
Rationale: Flow rate = (300 mL 15 gtt/mL) ÷ (2 60) = 4,500 ÷ 120 = 37.5 gtt/min, exactly matching option B.
A nurse is caring for a client who is taking oral Oxycodone The client states he is also taking lbuprofen in three recommended doses daily. The nurse should identify that an interaction between these two medications will cause which of the following findings?
- A. A decrease in serum levels of ibuprofen, possibly leading to a need for increased doses of this medication
- B. A decrease in serum levels of oxycodone, possibly leading to a need for increased doses of this medication
- C. An increase in the expected therapeutic effect of both medications
- D. An increase in expected adverse effects for both medications
Correct Answer: C
Rationale: Both are analgesics; combined use enhances pain relief , a therapeutic synergy, without necessarily increasing adverse effects.
A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes isotretinoin. The nurse reviews the client's medication record and would contact the (HCP) if the client is taking which medication?
- A. Vitamin A
- B. Digoxin (Lanoxin)
- C. Furosemide (Lasix)
- D. Phenytoin (Dilantin)
Correct Answer: A
Rationale: Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A supplements should be discontinued before isotretinoin therapy. Options 2, 3, and 4 are not contraindicated with the use of isotretinoin.
When prescribing temazepam (Restoril) for insomnia, patient education includes:
- A. Take temazepam nightly approximately 15 minutes before bedtime.
- B. Temazepam should not be used more than three times a week for less than 3 months.
- C. Drinking 1 ounce of alcohol will cause additive effects and the patient will sleep better.
- D. Exercise for at least 30 minutes within 2 hours of bedtime to enhance the effects of temazepam.
Correct Answer: B
Rationale: Temazepam is recommended short-term (e.g., ≤3 times/week) to avoid dependence.