Nokea
Risks to the fetus in the second trimester include:
- A. Exposure to teratogens causing abnormal organ development
- B. Maternal use of tobacco causing intrauterine growth restriction
- C. Maternal hypertension causing placental insufficiency
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because the second trimester involves growth, and tobacco restricts it via vasoconstriction, a key risk then. Choice A is incorrect as teratogens primarily affect organ development in the first trimester. Choice C is wrong because hypertension's placental effects are more third-trimester prominent. Choice D is incorrect since B is the specific second-trimester concern.
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Over-the-counter drugs that are safe to use include:
- A. Acetaminophen
- B. Aspirin
- C. Ibuprofen
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because acetaminophen, aspirin, and ibuprofen are safe OTC options for pain/fever when used per guidelines, with well-established profiles. Choice A is incorrect alone as it's one drug. Choice B is wrong by itself because aspirin is just part. Choice C is incorrect solo since ibuprofen is only one option.
The client is taking interferon alfa-2a (Roferon-A) and ribavirin (Virazole) combination therapy for hepatitis C and reports overwhelming feelings of depression. Which action should the nurse implement first?
- A. Recommend mental health counseling.
- B. Review the medication actions and interactions.
- C. Assess the client's daily activity level.
- D. Provide information about a support group.
Correct Answer: B
Rationale: The priority action for the nurse is to review the medication actions and interactions. Interferon alfa-2a and ribavirin combination therapy for hepatitis C can lead to neuropsychiatric side effects, including depression. By assessing the medication actions and interactions, the nurse can identify if the depression is a known side effect of the medications, and further intervention or adjustment of the treatment plan may be required to address the client's emotional well-being. Recommending mental health counseling (choice A) may be necessary but should come after ensuring that the depression is not solely caused by medication side effects. Assessing the client's daily activity level (choice C) and providing information about a support group (choice D) are important interventions but addressing the medication's potential contribution to the depression takes precedence.
Food or drink that should be avoided when taking a prescription for simvastatin includes:
- A. Milk
- B. Orange juice
- C. Grapefruit juice
- D. Green leafy vegetables
Correct Answer: C
Rationale: Choice C is correct because grapefruit juice inhibits CYP3A4, which metabolizes simvastatin, increasing drug levels and rhabdomyolysis risk, so it's to be avoided. Choice A is incorrect as milk doesn't affect simvastatin significantly. Choice B is wrong because orange juice has no notable interaction. Choice D is incorrect since green leafy vegetables don't impact simvastatin metabolism.
What predisposing factor most likely contributed to the proximal end of the femur fracture in a 62-year-old woman who lives alone and tripped on a rug in her home?
- A. Failing eyesight leading to an unsafe environment
- B. Renal osteodystrophy from chronic kidney disease (CKD)
- C. Osteoporosis from declining hormone levels
- D. Cerebral vessel changes causing transient ischemic attacks
Correct Answer: C
Rationale: The most likely predisposing factor contributing to the proximal end of the femur fracture in a 62-year-old woman is osteoporosis resulting from declining hormone levels. Osteoporosis weakens the bones, making them more susceptible to fractures, especially in older adults, particularly women. In this case, the fracture can be attributed to the bone density loss associated with osteoporosis, which is a common concern in postmenopausal women. Choices A, B, and D are less likely to have directly contributed to the femur fracture in this scenario. Failing eyesight may increase the risk of falls but does not directly weaken the bones. Renal osteodystrophy affects bone health but is less common in this age group. Cerebral vessel changes causing transient ischemic attacks are related to vascular issues, not bone strength.
An NP is prescribing a medication for a 6-month-old infant. The medication comes in the following formulations. Which one should the NP select to improve absorption and distribution of the medication?
- A. Oral elixir
- B. Rectal suppository
- C. Lipid soluble compound
- D. Sustained-release capsule
Correct Answer: A
Rationale: The correct answer is A because oral elixirs ensure even drug distribution and good GI absorption in infants. Choice B is incorrect (rectal absorption is unreliable). Choice C is wrong (lipid solubility doesn’t ensure distribution). Choice D is inaccurate (sustained-release is poorly absorbed in infants).