Nokea
Samantha is taking lamotrigine (Lamictal) for her seizures and requests a prescription for combined oral contraceptives (COCs), which interact with lamotrigine and may cause:
- A. Contraceptive failure
- B. Excessive weight gain
- C. Reduced lamotrigine levels, requiring doubling the dose of lamotrigine
- D. Induction of estrogen metabolism, requiring higher estrogen content OCs be prescribed
Correct Answer: C
Rationale: COCs induce lamotrigine metabolism, lowering its levels and requiring dose adjustment.
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When the costs of a specific treatment or intervention are calculated and then compared with the dollar value of the benefit received it is referred to as:
- A. Cost-minimization analysis
- B. Cost-of-illness analysis
- C. Cost-effectiveness analysis
- D. Cost-benefit analysis
Correct Answer: D
Rationale: Cost-benefit analysis quantifies both costs and benefits in monetary terms.
The nurse is discussing smoking cessation with a nurse colleague who smokes. Which statement indicates a readiness to quit smoking?
- A. I don't smoke around my children or inside the house
- B. I want to stop smoking, but I will need help to do it
- C. I will quit so my co-workers will stop harassing me about it
- D. If I cut down gradually, I should be able to quit
Correct Answer: B
Rationale: Readiness shows intent and help-seeking; external pressure or gradual cutdown don't confirm it. Patients exhibit readiness when they state a desire to quit along with a request for professional assistance.
A newly developed medication for pulmonary hypertension targets blood vessels in the lungs, but does not affect blood vessels in the liver. Which of the following is most likely true of this medication?
- A. It is a ligand that is specific for lung and liver blood-vessel receptors. but which is metabolized rapidly in the liver
- B. It is a ligand that is specific for blood-vessel receptors in the lung but not in the liver
- C. It is a receptor that is upregulated when oxygen tension in the lungs is low
- D. It is a receptor that is only expressed on blood vessels in the lungs
Correct Answer: B
Rationale: The medication's specificity for lung blood vessels suggests it targets receptors unique to that tissue, not the liver.
Chlorpromazine can block following receptors EXCEPT:
- A. Dopamine
- B. Beta adrenergic
- C. Alpha adrenergic
- D. Muscarinic
Correct Answer: B
Rationale: Chlorpromazine, a typical antipsychotic, blocks dopamine, alpha-adrenergic, and muscarinic receptors but has minimal effect on beta-adrenergic receptors, which are not its primary target.
When moving to another state, what is the nurse responsible for becoming familiar with?
- A. Local policies and procedures for controlled substance administration
- B. Local provider's Drug Enforcement Agency (DEA) number for prescribing controlled substances
- C. The agency monitoring controlled substances in the new state
- D. Board of Nursing regulations of controlled substances in the new state
Correct Answer: A
Rationale: The nurse needs to learn local policies and procedures for controlled substance administration because they can vary with some local governments more rigorous than others. Nurses do not memorize a provider's DEA numbers. The DEA is a federal agency that monitors controlled substances in all states. State boards of nursing do not regulate controlled substances but may regulate how controlled substances are administered by nurses.