Nokea
The following drug is not secreted in bile
- A. Penicillin
- B. Phenolphthalein
- C. Novobiocin
- D. Erythromycin
Correct Answer: A
Rationale: Penicillin is excreted via kidneys; others are secreted in bile.
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The student nurse asks the instructor why a patient with a central nervous system infection is receiving antibiotics that will not cross the blood-brain barrier. What is the instructor's most correct response?
- A. A severe infection alters the blood-brain barrier to allow the drug to cross.
- B. A medication that is water soluble is more likely to cross the blood-brain barrier.
- C. Antibiotics are the exception to the blood-brain barrier and cross easily.
- D. An infection that spreads outside the central nervous system helps drugs cross the barrier.
Correct Answer: A
Rationale: Effective antibiotic treatment can occur only when the infection is severe enough to alter the blood-brain barrier and allow antibiotics to cross. Lipid-soluble, not water-soluble, medications cross the blood-brain barrier more easily and most antibiotics are lipid soluble, so they are not the exception. No matter where the infection originates, drugs must cross the blood-brain barrier to treat central nervous system infections.
A patient arrives in the emergency department in an acute state of alcohol intoxication and reports chronic consumption of several six packs of beer every day for the past year. The nurse anticipates administering which medication or treatment?
- A. Chlordiazepoxide (Librium)
- B. Disulfiram (Antabuse)
- C. Gastric lavage
- D. Vasoconstrictors
Correct Answer: A
Rationale: Chlordiazepoxide prevents alcohol withdrawal symptoms; disulfiram is post-detox. To prevent acute withdrawal and delirium tremens, a long-acting benzodiazepine, such as chlordiazepoxide, is given.
A patient is being treated with isoniazid (INH), rifampin, and pyrazinamide in phase I of treatment for tuberculosis. The organism develops resistance to isoniazid. Which drug will the nurse anticipate the provider will order to replace the isoniazid?
- A. Ciprofloxacin (Cipro)
- B. Ethambutol (Myambutol)
- C. Kanamycin
- D. Streptomycin sulfate
Correct Answer: B
Rationale: Ethambutol replaces INH in phase I if resistance occurs; ciprofloxacin or kanamycin are less common first-line options. If there is bacterial resistance to isoniazid, the first phase may be changed to ethambutol, rifampin, and pyrazinamide.
All of the following are adverse effects of phenothiazines except
- A. Rigidity and tremor
- B. Menstrual irregularities
- C. Cholestatic jaundice
- D. Systolic hypertension
Correct Answer: D
Rationale: Phenothiazines cause hypotension, not hypertension.
After completing a course on pharmacology for nurses, what will the nurse know?
- A. Everything necessary for safe and effective medication administration
- B. Current pharmacologic therapy; the nurse will not require ongoing education for 5 years.
- C. General drug information; the nurse can consult a drug guide for specific drug information.
- D. The drug actions that are associated with each classification of medication
Correct Answer: C
Rationale: After completing a pharmacology course nurses will have general drug information needed for safe and effective medication administration but will need to consult a drug guide for specific drug information before administering any medication. Pharmacology is constantly changing, with new drugs entering the market and new uses for existing drugs identified. Continuing education in pharmacology is essential to safe practice. Nurses tend to become familiar with the medications they administer most often, but there will always be a need to research new drugs and also those the nurse is not familiar with because no nurse knows all medications.