Nokea
Several processes enable a drug to reach a specific concentration in the body. Together they are called dynamic equilibrium. What are these processes? (Select one that does not apply.)
- A. Distribution to the active site
- B. Biotransformation
- C. Absorption from the muscle
- D. Excretion
Correct Answer: C
Rationale: The actual concentration that a drug reaches in the body results from a dynamic equilibrium involving several processes: Absorption from the site of entry (can be from the muscle, the gastrointestinal (GI) tract if taken orally, of the subcutaneous tissue if given by that route); Distribution to the active site; biotransformation (metabolism) in the liver; excretion from the body. Interaction with other drugs is not part of the dynamic equilibrium.
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A patient who takes an oral sulfonylurea medication will begin taking fluconazole (Diflucan). The nurse will expect to monitor which lab values in this patient?
- A. Blood urea nitrogen (BUN) and creatinine
- B. Electrolytes
- C. Fluconazole levels
- D. Glucose
Correct Answer: D
Rationale: Fluconazole inhibits CYP450, increasing sulfonylurea levels and hypoglycemia risk; glucose monitoring is key. Patients taking sulfonylurea drugs may have altered serum glucose when taking antifungal medications.
The nurse, working on the maternity unit, receives a call from a pregnant woman asking how she can know whether a medication is safe to take while pregnant. What is the nurses best response?
- A. You can take any drug indicated as a Category A.
- B. No medications should be taken during pregnancy.
- C. Never take medication until you receive approval from your health care provider.
- D. Most medications are safe but you need to weigh benefit against risk.
Correct Answer: C
Rationale: The best response to a pregnant woman asking about medication usage is to talk with her obstetric practitioner because the best advice will come from someone who knows their health and pregnancy history. While Category A drugs have no known risk, they may be contraindicated by the woman's health condition or pregnancy issues and many pregnant women would not know what it means to be a Category A drug. Medications can be helpful during pregnancy if taken safely and appropriately. Although risk benefit needs to be weighed, it should occur with advice from the obstetric practitioner.
A nurse is instructing a client who has a new prescription for Timolol how to insert eye drops. The nurse should instruct the client to press on which of the following areas to prevent systemic absorption of the medication?
- A. Bony orbit
- B. Nasolacrimal duct
- C. Conjunctival sac
- D. Outer canthus
Correct Answer: B
Rationale: Pressing the nasolacrimal duct prevents systemic absorption by blocking drainage into the nasal cavity.
The student nurses are learning to weigh patients and do vital signs. Weighing a client is a nursing intervention that is most important for what?
- A. Dosage calculation
- B. Assessing changes in fluid balance
- C. Assessing changes in nutritional status
- D. Caloric needs
Correct Answer: B
Rationale: Weighing assesses fluid balance changes, vital for adjusting drugs like diuretics in conditions such as CHF.
A nurse is preparing a prescribed dose of rabeprazole for a client with gastric ulcers. The nursing drug guide does not list treatment of gastric ulcers among the recognized indications for this drug. What should the nurse do?
- A. Administer the drug as ordered
- B. Clarify with the prescriber concerning the ordered drug
- C. Document this potential error in the client's health record
- D. Ask the client whether he or she has taken this drug before
Correct Answer: B
Rationale: Rabeprazole is typically for GERD, not gastric ulcers per standard indications; clarifying with the prescriber ensures safety and appropriateness.