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Selma, who is overweight, recently started taking topiramate for seizures and at her follow-up visit you note she has lost 3 kg. The appropriate action would be:
- A. Tell her to increase her caloric intake to counter the effects of the topiramate.
- B. Consult with a neurologist, as this is not a common adverse effect of topiramate.
- C. Decrease her dose of topiramate.
- D. Reassure her that this is a normal side effect of topiramate and continue to monitor her weight.
Correct Answer: D
Rationale: Weight loss is a common, beneficial side effect of topiramate.
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A nurse is administering digoxin to a patient. To administer medications so that the drug is as effective as possible, the nurse needs to consider what?
- A. Pharmacotherapeutics
- B. Pharmacokinetics
- C. Pharmacoeconomics
- D. Pharmacogenomics
Correct Answer: B
Rationale: When administering a drug, the nurse needs to consider the phases of pharmacokinetics so that the drug regimen can be made as effective as possible. Pharmacogenomics is the area of study that includes mapping of the human genome. Pharmacotherapeutics is the branch of pharmacology that deals with the uses of drugs to treat, prevent, and diagnose disease. Pharmacoeconomics includes all costs involved in drug therapy.
Children who should receive meningococcal conjugate vaccine (Hib-MenCY, MenHibrix) include:
- A. Children traveling to the Haj
- B. Infants, routinely at 2, 4, 6, and 12 to 15 months
- C. Infants with functional asplenia (including sickle cell disease)
- D. Two-year olds with complement deficiencies
Correct Answer: C
Rationale: Hib-MenCY is indicated for infants with asplenia (e.g., sickle cell); Haj travel applies to older meningococcal vaccines.
Which is true regarding the unit dose drug distribution system?
- A. The inventory is delivered to each nursing unit on a regular and recurring basis.
- B. The system delivers one dose of each medication to be administered until the subsequent delivery of inventory.
- C. The use of single dose packages of drugs dispensed to fill each dose requirement as it is ordered.
- D. The amount of inventory needed to dose all patients on the unit for a 24 hour interval.
Correct Answer: C
Rationale: The unit dose drug distribution system uses single unit packages of drugs dispensed to fill each dose requirement as it is ordered.
Strategies prescribers can use to prevent misuse of controlled prescription drugs include:
- A. Use of chemical dependency screening tools
- B. Firm limit-setting regarding prescribing controlled substances
- C. Practicing 'just say no' to deal with patients who are pushing the provider to prescribe controlled substances
- D. All of the above
Correct Answer: D
Rationale: All strategies "screening , limits , and refusal "help prevent misuse of controlled substances.
The following are recognized effects of propranolol except
- A. Increases microcoronary blood flow
- B. Decrease in heart rate
- C. Decrease in cardiac output
- D. Reduction in ventricular systolic pressure
Correct Answer: A
Rationale: Propranolol reduces coronary flow; other effects are correct.