Nokea
The factor that most determines drug distribution is:
- A. vascular perfusion of the tissue or organ.
- B. salt form.
- C. drug interactions.
- D. steady state.
Correct Answer: A
Rationale: Drugs are distributed via the circulatory system. Adequate perfusion is necessary for distribution of a drug. The other choices are not as dependent on adequate perfusion.
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The nurse telephones the HCP to request a pm anxiolytic medication order for a hospitalized client having occasional anxiety. Which medication, if prescribed, should the nurse question regarding its effectiveness for prn use?
- A. Buspirone
- B. Lorazepam
- C. Clorazepate
- D. Clonazepam
Correct Answer: A
Rationale: Buspirone (BuSpar) has a 10- to 14-day delay in therapeutic onset, making it unsuitable for prn use.
The client has an order for an IV piggyback of Ceftriaxone 750 mg in 50 mL D5W to run over 30 minutes. What is the appropriate drip rate?
- A. 100 mL/hr
- B. 150 mL/hr
- C. 200 mL/hr
- D. 50 mL/hr
Correct Answer: A
Rationale: (50 mL / 30 min) × (60 min / 1 hr) = 100 mL/hr
The client is beginning treatment with bupropion for depression. After meeting with the HCP, the client tells the nurse, “I'm also taking Zyban to help me stop smoking.†Which is the most appropriate action for the nurse?
- A. Encourage and support the client in following the smoking cessation regimen.
- B. Provide the client with the telephone number for a smoking cessation support group.
- C. Instruct the client to report any allergic-type reactions after beginning the bupropion.
- D. Inform the HCP that the client is already taking bupropion, but for smoking cessation.
Correct Answer: D
Rationale: Bupropion (Zyban) should not be used for multiple conditions simultaneously due to the risk of seizures from additive doses.
The 14-year-old who has GERD is receiving lansoprazole. Which response should the nurse expect if lansoprazole is achieving the desired therapeutic effect?
- A. Increased appetite
- B. Increased GI motility
- C. Decreased epigastric pain
- D. Decreased rectal flatulence
Correct Answer: C
Rationale: A: Lansoprazole would not be expected to change appetite. B: Lansoprazole is not a gastric motility agent. C: Lansoprazole (Prevacid) is a PPI of stomach acid secretion. Decreasing the overall pH allows the gastric mucosa to heal. D: Flatulence is not affected.
The nurse is providing teaching to the client receiving a thiazide diuretic. Which points should the nurse plan to include? Select all that apply.
- A. Take the radial pulse before setting up the medication.
- B. Include fruits such as melons and bananas in the diet.
- C. Report side effects such as muscle cramps, nausea, or a skin rash.
- D. Take the last dose at bedtime when fluids are at the highest level.
- E. Avoid high-fat foods; thiazide diuretics increase cholesterol levels.
Correct Answer: B,C,E
Rationale: A: It is unnecessary for the client to monitor the pulse prior to taking thiazide diuretics. B: Thiazide diuretics can cause hypokalemia, and potassium-rich foods can help maintain potassium levels. C: Muscle cramps are a sign of possible medication side effects of hypokalemia and hypocalcemia. Nausea and rash are also medication side effects. D: A diuretic taken at bedtime can cause nocturia and loss of sleep. The usual timing of the last daily dose of a diuretic is at suppertime. E: Thiazide diuretics can increase serum cholesterol, LDL, and triglyceride levels, so teaching the client to avoid high-fat foods will help maintain cholesterol levels.