Nokea
The client with small cell lung cancer is being treated with etoposide (VePesid). The nurse who is assisting in caring for the client during its administration understands that which side effect is specifically associated with this medication?
- A. Alopecia
- B. Chest pain
- C. Pulmonary fibrosis
- D. Orthostatic hypotension
Correct Answer: D
Rationale: A side effect specific to etoposide is orthostatic hypotension. The client's blood pressure is monitored during the infusion. Hair loss occurs with nearly all the antineoplastic medications. Chest pain and pulmonary fibrosis are unrelated to this medication.
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David presents to the clinic with symptoms of allergic conjunctivitis. He is prescribed cromolyn sodium (Opticrom) eye drops. The education regarding using cromolyn eye drops includes:
- A. He should not wear his soft contacts while using the cromolyn eye drops
- B. Cromolyn drops are instilled once a day to prevent allergy symptoms
- C. Long-term use may cause glaucoma
- D. He may experience bradycardia as an adverse effect
Correct Answer: A
Rationale: Cromolyn can irritate soft contacts, requiring removal; it's not once daily or linked to glaucoma .
The nurse receives an order to administer an unfamiliar medication and obtains a nurse's drug guide published four years earlier. What is the nurse's most prudent action?
- A. Find a more recent reference source.
- B. Use the guide if the drug is listed.
- C. Ask another nurse for drug information.
- D. Verify the information in the guide with the pharmacist.
Correct Answer: A
Rationale: The nurse is responsible for all medications administered and must find a recent reference source to ensure the information learned about the medication is correct and current. Using an older drug guide could be dangerous because it would not contain the most up-to-date information. Asking another nurse or the pharmacist does not guarantee accurate information will be obtained and could harm the patient if the information is wrong.
An order is written for oxazepam for a 6-year-old child. The nurse notices that there is no established dosage for children 6 to 12 years of age. Knowing that the usual adult dose is 10 mg t.i.d., what would the nurse calculate the appropriate dose to be?
- A. 0.03 mg t.i.d.
- B. 0.3 mg t.i.d.
- C. 1.8 mg t.i.d.
- D. 3.3 mg t.i.d.
Correct Answer: D
Rationale: Because the nurse only knows the child's age, the nurse would need to use Young's Rule to determine the appropriate dosage. Use the formula, child's dose equals the age of the child in years divided by the child's age plus 12 times the average adult dose to calculate the answer. Dose = (6/[6+12]) 10 mg (6/18 = 0.33 10 = 3.3).
Select the most appropriate drug for regular prophylactic therapy in a 10 year old child who suffers from exercise induced asthma:
- A. Oral salbutamol
- B. Oral theophylline
- C. Inhaled sodium cromoglycate
- D. Inhaled salmeterol
Correct Answer: C
Rationale: Inhaled sodium cromoglycate is preferred for prophylaxis in exercise-induced asthma in children, stabilizing mast cells to prevent bronchoconstriction; salmeterol is a long-acting option but less favored.
Immunosupressive effects of glucocorticoids are denominated with:
- A. Decrease of interleukins 1,2
- B. Activation of lymphocyte proliferation
- C. Increase amount of T lymphocytes
- D. Activation of lymphocyte transport at the site of antigen stimulation
Correct Answer: A
Rationale: Glucocorticoids suppress immunity by decreasing pro-inflammatory cytokines like interleukins 1 and 2.