Nokea
The client is taking methylphenidate sustained-release tablets once daily for attention deficit disorder. The medication peaks in 4 to 7 hours and has a duration of 12 hours. At which time should the nurse instruct the client to take the prescribed dose of methylphenidate?
- A. At bedtime
- B. With the midday meal
- C. Six hours before bedtime
- D. Upon waking in the morning
Correct Answer: D
Rationale: Sustained-release methylphenidate (Ritalin) should be taken in the morning to avoid sleep interference.
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The new nurse asks the experienced nurse why the first dose of the MMR vaccine is normally given at 12 to 15 months of age and not earlier, except with international travel. Which explanation by the experienced nurse is correct?
- A. Giving the first dose of the vaccine at 12 to 15 months of age allows the correct interval before the next booster at age 12 years.
- B. A live virus is being given; the chance of measles, mumps, or rubella developing is much higher if given at an earlier age.
- C. A first dose at this age provides passive immunity and decreases the incidence of a child developing any of the diseases.
- D. If given earlier, the vaccine may neutralize the passive immunity to measles from the child's mother and no immunity may result.
Correct Answer: D
Rationale: A: The second dose of the MMR vaccine can be given earlier, provided that at least 4 weeks has elapsed since the first dose. However, a second dose is usually not given earlier because sufficient immunity is usually present. B: The chance of developing only measles is greater if the vaccine is given at a younger age because the vaccine may neutralize the passive antibodies. C: The MMR provides active (not passive) immunity. D: Because the MMR vaccine is a live virus, a person develops a mild form of the diseases after administration, stimulating the body to develop immunity. The passively acquired antibodies to measles can interfere with the child's immune response to the vaccine, and no immunity may result.
The nurse administers risperidone to the client experiencing hallucinations. Which physiological disorder should the nurse assess for considering the risk of developing this disorder as a side effect of risperidone?
- A. Asthma
- B. Hypertension
- C. Crohn's disease
- D. Diabetes mellitus
Correct Answer: D
Rationale: Risperidone (Risperdal) increases the risk of diabetes, especially in the first few months of therapy.
The nurse is assessing the laboratory test results for the male client receiving testosterone replacement therapy for treatment of hypogonadism. Which laboratory test result is most important for the nurse to review?
- A. Fasting lipid profile
- B. Partial thromboplastin time
- C. Urinalysis
- D. Serum potassium
Correct Answer: A
Rationale: A: The most important test is the fasting lipid profile because testosterone can lower plasma levels of HDLs and elevate plasma levels of LDLs, increasing the risk of atherosclerosis. B: Testosterone has little effect on PTT. C: Testosterone has little effect on urine. D: Testosterone has little effect on serum potassium.
While the nurse is completing the assessment of the child with Reye's syndrome, the parent states that multiple OTC medications were given before hospitalization to treat the child's influenza symptoms. Which medication stated by the parent is most important for the nurse to report to the HCP?
- A. Acetaminophen
- B. Bismuth subsalicylate
- C. Pseudoephedrine
- D. Diphenhydramine
Correct Answer: B
Rationale: A: Acetaminophen (Tylenol) is an aspirin-free analgesic and antipyretic. B: Although the etiology of Reye's syndrome is unknown, the condition typically occurs after a viral illness, such as influenza, and is associated with aspirin (acetylsalicylic acid) use during the illness. Bismuth subsalicylate (Pepto-Bismol) contains aspirin. C: Pseudoephedrine (Sudafed) is an allergy and/or cold remedy used for nasal drying and decongestion. This does not contain aspirin. D: Diphenhydramine (Benadryl) is an antihistamine. This does not contain aspirin.
An allergic reaction is classified as what type of pharmacological effect?
- A. a therapeutic effect
- B. a side effect
- C. an adverse effect
- D. an incompatibility
Correct Answer: C
Rationale: An allergic reaction is considered an adverse effect, as it is unintended and requires treatment. A side effect is also undesired but is somewhat expected, and a side effect does not require intervention.