Nokea
Strategies to prevent misuse of prescription drugs include:
- A. Using prescription drug monitoring programs
- B. Educating patients about risks
- C. Prescribing the lowest effective dose
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because PDMPs track dispensing, education deters misuse, and lowest doses minimize excess—all proven prevention methods. Choice A is incorrect alone as it's one tool. Choice B is wrong by itself because education is just part. Choice C is incorrect solo since dosing is only one strategy.
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A client is wearing a continuous cardiac monitor, which begins to alarm at the nurse's station. The nurse sees no electrocardiographic complexes on the screen. What should the nurse do first?
- A. Call a code blue.
- B. Call the healthcare provider.
- C. Check the client's status and lead placement.
- D. Press the recorder button on the ECG console.
Correct Answer: C
Rationale: The correct first action for the nurse to take is to check the client's status and lead placement. This step is crucial to ensure that the alarm is not triggered by a simple issue such as lead displacement. Calling a code blue (choice A) is premature without assessing the client first. Contacting the healthcare provider (choice B) can be done after ruling out basic causes for the alarm. Pressing the recorder button (choice D) is not as urgent as checking the client's status and lead placement in this scenario.
A client with a history of angina pectoris reports chest pain while ambulating in the corridor. What should the nurse do first?
- A. Check the client's vital signs.
- B. Assist the client to sit or lie down.
- C. Administer sublingual nitroglycerin.
- D. Apply nasal oxygen at a rate of 2 L/min.
Correct Answer: B
Rationale: When a client with a history of angina pectoris experiences chest pain while ambulating, the priority action for the nurse is to assist the client to sit or lie down. This helps reduce the demand on the heart by decreasing physical exertion. Checking vital signs, administering medication, or applying oxygen can follow once the client is in a more comfortable position. Checking vital signs (Choice A) may be important but addressing the immediate discomfort by positioning the client comfortably takes precedence. Administering sublingual nitroglycerin (Choice C) is appropriate but should come after ensuring the client's comfort. Applying nasal oxygen (Choice D) can be beneficial, but it should not be the first action; assisting the client to sit or lie down is the initial priority.
VKORC1 genetic variations would affect which drug?
- A. Warfarin
- B. Codeine
- C. Acetaminophen
- D. All of the above
Correct Answer: A
Rationale: Choice A is correct because VKORC1 variants alter warfarin's target enzyme, affecting its anticoagulant effect and requiring dose adjustments. Choice B is incorrect as codeine's action is CYP2D6-mediated, not VKORC1-related. Choice C is wrong because acetaminophen doesn't interact with VKORC1—it's unrelated to coagulation. Choice D is incorrect since only warfarin is impacted by VKORC1 genetics.
A client has a new prescription for verapamil. Which of the following beverages should the client avoid while taking this medication?
- A. Orange juice
- B. Coffee
- C. Milk
- D. Grapefruit juice
Correct Answer: D
Rationale: Grapefruit juice should be avoided while taking verapamil as it can increase drug levels and the risk of side effects. The interaction between grapefruit juice and verapamil can lead to higher concentrations of the medication in the bloodstream, potentially causing adverse effects. Orange juice, coffee, and milk do not have significant interactions with verapamil. Therefore, it is crucial for the client to avoid grapefruit juice to ensure the safe and effective use of verapamil.
A woman who is pregnant develops gestational diabetes. The NP's initial action is to:
- A. prescribe an oral antidiabetic agent.
- B. give her information about diet and exercise.
- C. begin treating her with daily insulin injections.
- D. reassure her that her glucose levels will return to normal after pregnancy.
Correct Answer: B
Rationale: The correct answer is B because diet and exercise are the initial management for gestational diabetes. Choice A is incorrect (oral agents lack sufficient safety data). Choice C is wrong (insulin isn’t first-line). Choice D is inaccurate (reassurance alone doesn’t address current needs).