Nokea
The elderly are at high risk of ADRs due to:
- A. Having greater muscle mass than younger adults, leading to higher volume of distribution
- B. The extensive studies that have been conducted on drug safety in this age group
- C. The blood-brain barrier being less permeable, requiring higher doses to achieve therapeutic effect
- D. Age-related decrease in renal function
Correct Answer: D
Rationale: Age-related renal decline slows drug clearance, raising ADR risk in the elderly, unlike muscle mass , studies , or BBB .
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A man is given a drug to reduce thyroid gland size and vascularity before surgical thyroidectomy. Which mechanism is responsible for its use in this setting?
- A. inhibition of the sodium/iodide symporter
- B. inhibition of thyroperoxidase
- C. inhibition of TSH secretion
- D. inhibition of thyroid hormone release
Correct Answer: D
Rationale: Inhibition of thyroid hormone release (e.g., by iodides) reduces gland size and vascularity pre-surgery.
The nurse is discussing smoking cessation with a nurse colleague who smokes. Which statement indicates a readiness to quit smoking?
- A. I don't smoke around my children or inside the house
- B. I want to stop smoking, but I will need help to do it
- C. I will quit so my co-workers will stop harassing me about it
- D. If I cut down gradually, I should be able to quit
Correct Answer: B
Rationale: Readiness shows intent and help-seeking; external pressure or gradual cutdown don't confirm it. Patients exhibit readiness when they state a desire to quit along with a request for professional assistance.
Samantha is taking lamotrigine (Lamictal) for her seizures and requests a prescription for combined oral contraceptives (COCs), which interact with lamotrigine and may cause:
- A. Contraceptive failure
- B. Excessive weight gain
- C. Reduced lamotrigine levels, requiring doubling the dose of lamotrigine
- D. Induction of estrogen metabolism, requiring higher estrogen content OCs be prescribed
Correct Answer: C
Rationale: COCs induce lamotrigine metabolism, lowering its levels and requiring dose adjustment.
A nurse is preparing to administer an intramuscular injection to a patient for the first time. Which of the following would be most important for the nurse to do?
- A. Obtain the patient's allergy history.
- B. Obtain information about the drug.
- C. Inquire if the patient has any objections to syringes.
- D. Discuss the dosage with other nurses.
Correct Answer: A
Rationale: Before giving any drug for the first time, the nurse should ask the patient about any known allergies as well as any family history of allergies. The nurse need not particularly obtain information about the drug as it has been prescribed by the physician, but needs to be aware of the adverse effects it may cause. There is also no need to discuss the dosage with other nurses or to find out if the client has any objections to syringes. However, the nurse should help allay the patient's fears by reassuring him or her about the administration.
A patient's liquid cough medicine has been discontinued with one half of the bottle remaining. The home health nurse is aware that according to the U.S. Food and Drug Administration (FDA) guidelines on prescription medication disposal, the next step should be to:
- A. save the remainder for another patient with the same prescription.
- B. flush the remainder down the toilet.
- C. read the drug label for specific disposal instructions.
- D. pour remaining medication into a hazardous waste container.
Correct Answer: C
Rationale: The nurse must follow specific disposal instructions on the drug label or in the patient information leaflet that accompanies the medication. Prescription medications should not be shared among patients. Prescription drugs should not be flushed down the toilet unless specifically instructed to do so by the manufacturer. The first action to be taken is to follow disposal instructions on the label. If the drug label indicates it should be emptied into a hazardous waste container, measures should be taken to prevent leaking and/or accidental ingestion.