Nokea
The clinic nurse is performing an admission assessment on a client. The nurse notes that the client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the client is being treated for:
- A. Acne
- B. Eczema
- C. Hair loss
- D. Herpes simplex
Correct Answer: A
Rationale: Azelaic acid is a topical medication used to treat mild to moderate acne. The acid appears to work by suppressing the growth of Propionibacterium acnes and decreasing the proliferation of keratinocytes. Options 2, 3, and 4 are incorrect.
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You are to infuse 1,200 mL of IV fluid over 6 hours using a drop factor of 10 gtt/mL. What is the flow rate in drops per minute?
- A. 30 gtt/min
- B. 33 gtt/min
- C. 40 gtt/min
- D. 50 gtt/min
Correct Answer: B
Rationale: Flow rate = (1,200 mL 10 gtt/mL) ÷ (6 60) = 12,000 ÷ 360 = 33.33 gtt/min, rounded to 33 gtt/min.
Up to 21% of Asians are ultra-rapid 2D6 metabolizers, requiring:
- A. A need to monitor drugs metabolized by 2D6 for toxicity
- B. Increased dosages needed of drugs metabolized by 2D6, such as the selective serotonin reuptake inhibitors
- C. Decreased conversion of codeine to morphine by CYP 2D6
- D. The need for lowered dosages of drugs, such as beta blockers
Correct Answer: B
Rationale: Ultra-rapid 2D6 metabolizers (e.g., in Asians) need higher SSRI doses due to fast metabolism, unlike toxicity , codeine issues , or lower doses .
Nonselective beta blockers and alcohol create serious drug interactions with insulin because they:
- A. Increase blood glucose levels
- B. Produce unexplained diaphoresis
- C. Interfere with the ability of the body to metabolize glucose
- D. Mask the signs and symptoms of altered glucose levels
Correct Answer: D
Rationale: Nonselective beta blockers and alcohol mask hypoglycemia symptoms (e.g., tachycardia), complicating detection.
Adherence to beta blocker therapy may be affected by their:
- A. Short half-lives requiring twice daily dosing
- B. Tendency to elevate lipid levels
- C. Effects on the male genitalia, which may produce impotence
- D. None of the above
Correct Answer: C
Rationale: Impotence is a known side effect that can reduce adherence to beta blockers.
A patient tells the clinic nurse that he or she has been taking over-the-counter (OTC) Pepcid to relieve acid indigestion for several years. This is the first time the patient has ever reported this issue to a health care provider. As part of the teaching plan for this patient, the nurse explains what risk associated with not sharing OTC drug use with the provider?
- A. The OTC drug could be more expensive than seeking health care advice.
- B. The drug could mask symptoms of a serious problem that is undiagnosed.
- C. Use of the drug could cause a rebound effect of Pepcid.
- D. The drug could interact with several cold medicines.
Correct Answer: B
Rationale: OTC drugs allow patients to self-diagnose and treat routine signs and symptoms without seeing a health care provider. This self-prescribed treatment, however, could mask a more serious underlying medical problem and result in a poor outcome for the patient. The issues of drug rebound and drug interaction need to be considered, but the safety issue related to self-diagnosis and self-prescription presents the greatest risk to the patient. Patients should always be encouraged to discuss the use of OTC products with their health care provider.