Nokea
The choice of diuretic to use in treating hypertension is based on:
- A. Presence of diabetes with loop diuretics being used for these patients
- B. Level of kidney function with a thiazide diuretic being used for an estimated glomerular filtration rate higher than the mid-40 mL/min range
- C. Ethnicity with aldosterone antagonists best for African Americans and older adults
- D. Presence of hyperlipidemia with higher doses needed for patients with LDL above 130 mg/dL
Correct Answer: B
Rationale: Thiazides are effective with GFR >40-50 mL/min; loops are used for lower GFR.
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The physician has asked a nurse to administer a drug intravenously to a patient who is unresponsive. How can the nurse ensure that the drug is administered to the right patient?
- A. By waking him up to ask him his name
- B. By identifying the patient's room number
- C. By checking the patient's wristband
- D. By asking the nursing assistant for the patient's location
Correct Answer: C
Rationale: The nurse should identify a patient by checking his wristband, which has the patient's name. The nurse should not ask the patient to confirm his name, because some patients, particularly those who are confused or have difficulty hearing, may respond by answering yes. Additionally, this patient is unresponsive. The nurse can obtain the patient's location by asking any other member of the health care staff, but should verify the patient's identity by checking the wristband. The nurse should not rely on the patient's room number alone.
When patients are started on darbepoetin alfa (Aranesp) they need monitoring of their blood counts to determine a dosage adjustment in:
- A. 6 weeks if they are a cancer patient
- B. 1 week if they have chronic renal failure
- C. 2 weeks if they are taking it for allogenic transfusion
- D. Each week throughout therapy
Correct Answer: A
Rationale: Cancer patients need blood count checks at 6 weeks for darbepoetin adjustment; renal patients adjust sooner, typically 2-4 weeks.
Cara is taking levetiracetam (Keppra) to treat seizures. Routine education for levetiracetam includes reminding her:
- A. To not abruptly discontinue levetiracetam due to risk for withdrawal seizures
- B. To wear sunscreen due to photosensitivity from levetiracetam
- C. To get an annual eye exam while on levetiracetam
- D. To report weight loss if it occurs
Correct Answer: A
Rationale: Abrupt discontinuation of levetiracetam risks withdrawal seizures.
You are doing an admission assessment on a patient. During the medication history portion of the assessment what would be important to assess with herbal supplements?
- A. Research them for interactions with other medications
- B. Discontinue them if taking prescription medications
- C. Take them one hour before prescription medications
- D. Take them three hours after prescription medications
Correct Answer: A
Rationale: Researching herbal interactions ensures safe integration with prescribed drugs, preventing adverse effects.
A nurse is preparing to administer clindamycin 200 mg by intermittent IV bolus. The amount available is clindamycin injection 200 mg in 100 mL 0.9% sodium chloride (0.9% NaCl) to infuse over 30 min. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Do not use a trailing zero.)
- A. 200
- B. 180
- C. 250
- D. 500
Correct Answer: A
Rationale: Calculation: (100 mL / 30 min) 60 min/hr = 200 mL/hr, matching the provided answer.