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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The standard dosage of St John's wort for the treatment of mild depression is:
- A. 300 mg daily
- B. 100 mg three times a day
- C. 300 mg three times a day
- D. 600 mg three times a day
Correct Answer: C
Rationale: 300 mg three times daily is the standard dose for St John's wort in mild depression.
Laboratory monitoring for patients on angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers should include:
- A. White blood cell counts with the drug dosage increased for elevations above 10,000 feet
- B. Liver function tests with the drug dosage stopped for alanine aminotransferase values twice that of normal
- C. Serum creatinine levels with the drug dosage reduced for values greater than 2.5 mg/dL
- D. Serum glucose levels with the drug dosage increased for levels greater than 120 mg/dL
Correct Answer: C
Rationale: Elevated creatinine (>2.5 mg/dL) indicates renal impairment, requiring dose adjustment.
A group of nursing students are reviewing information about drug development in the United States in preparation for an exam. The students demonstrate understanding of this material when they identify testing of which of the following as one of the first steps?
- A. Small group of healthy volunteers
- B. People who have the disease
- C. Live animals
- D. Large numbers of patients
Correct Answer: C
Rationale: Initially, drug testing begins with testing in an artificial environment such as a test tube, and then this testing is followed by testing on live animals. Next, clinical testing occurs with each phase involving a larger number of people. First, a small group of 20 to 100 healthy volunteers are tested; then testing is performed on people who have the disease or condition. Last, the drug is given to large numbers of patients in medical research centers.
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.
The bronchodilator of choice for patients taking propranolol is:
- A. Albuterol
- B. Pirbuterol
- C. Formoterol
- D. Ipratropium
Correct Answer: D
Rationale: Ipratropium , an anticholinergic, avoids beta-blockade interference from propranolol, unlike beta-agonists .