Nokea
Rodrigo has been prescribed procainamide after a myocardial infarction. He is monitored for dyspnea, jugular venous distention, and peripheral edema because they may indicate:
- A. Widening of the area of infarction
- B. Onset of congestive heart failure
- C. An electrolyte imbalance involving potassium
- D. Renal dysfunction
Correct Answer: B
Rationale: These symptoms suggest heart failure, a potential procainamide complication.
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When determining drug treatment, the NP prescriber should:
- A. Always use evidence-based guidelines
- B. Individualize the drug choice for the specific patient
- C. Rely on his or her experience when prescribing for complex patients
- D. Use the newest drug on the market for the condition being treated
Correct Answer: B
Rationale: Individualizing treatment tailors therapy to the patient, balancing evidence and experience , while avoiding untested new drugs .
The nurse is preparing a medication that is new to the market and cannot be found in the nurse's drug guide. Where can the nurse get the most reliable information about this medication?
- A. Package insert
- B. Another nurse
- C. Drug manufacturer
- D. Physician
Correct Answer: A
Rationale: The most reliable information about the drug can be found on the package insert supplied by the manufacturer because it was prepared according to strict Food and Drug Administration (FDA) regulations. Asking another nurse or the physician is not reliable and cannot be verified as accurate. It would not be realistic to call the drug manufacturer for information.
A 49-year-old woman with a history of hypertension is treated with spironolactone. She has good blood pressure control and in the last 6 months has shown an improvement in her hirsutism. What is the most likely explanation for these findings?
- A. Androgen receptor inhibition of the hair follicle
- B. Drug toxicity
- C. Hypoaldosteronism
- D. Testosterone levels are elevated
Correct Answer: A
Rationale: Spironolactone's anti-androgenic effects inhibit androgen receptors, reducing hirsutism, alongside its aldosterone antagonism for hypertension.
A nurse is preparing a drug for administration to a patient. The drug does not have an indicated use for the patient's medical diagnosis. What should the nurse do?
- A. Administer the drug as ordered.
- B. Question the prescriber concerning the ordered drug.
- C. Ask a coworker his or her thoughts about the ordered drug for the patient.
- D. Ask the patient why the drug has been prescribed for him or her.
Correct Answer: B
Rationale: If the nurse is not sure about giving a drug, the order should be questioned. The nurse should never give a medication that is not clear. Mistakes do happen and the drug ordered, if not approved for the condition that the patient has, could be an error on someone's part. The person who wrote the order should be questioned, not a co worker, who probably does not know why an off-label drug is being used. It would be unprofessional and inappropriate to ask the patient about the drug.
A patient who is taking isoniazid (INH) as part of a two-drug tuberculosis treatment regimen reports tingling of the fingers and toes. The nurse will recommend discussing which treatment with the provider?
- A. Adding pyrazinamide
- B. Changing to ethambutol
- C. Increasing oral fluid intake
- D. Taking pyridoxine (B6)
Correct Answer: D
Rationale: Pyridoxine prevents INH-induced neuropathy (tingling); changing drugs or fluids doesn't address this. Peripheral neuropathy is an adverse reaction to INH, so pyridoxine is usually given to prevent this.