Nokea
The NP orders a thyroid panel for a patient on amiodarone. The patient tells the NP that he does not have thyroid disease and wants to know why the test is ordered. Which is a correct response?
- A. Amiodarone inhibits an enzyme that is important in making thyroid hormone and can cause hypothyroidism.
- B. Amiodarone damages the thyroid gland and can result in inflammation of that gland, causing hyperthyroidism.
- C. Amiodarone is a broad-spectrum drug with many adverse effects. Many different tests need to be done before it is given.
- D. Amiodarone can cause corneal deposits in up to 25% of patients.
Correct Answer: A
Rationale: Amiodarone inhibits thyroid hormone synthesis, risking hypothyroidism.
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Richard is 70 years old and has a history of cardiac dysrhythmias. He has been prescribed nadolol. You do his annual laboratory work and find a CrCl of 25 ml/min. What action should you take related to his nadolol?
- A. Extend the dosage interval.
- B. Decrease the dose by 75%.
- C. Take no action because this value is expected in the older adult.
- D. Schedule a serum creatinine level to validate the CrCl value.
Correct Answer: A
Rationale: Reduced renal clearance (CrCl 25 ml/min) requires extending the dosage interval for nadolol.
A nurse is caring for a client who states she has been taking Phenylephrine nasal drops for the past 10 days for Sinusitis. The nurse should assess the client for which of the following adverse effects of this medication?
- A. Sedation
- B. Nasal congestion
- C. Productive cough
- D. Constipation
Correct Answer: B
Rationale: Prolonged phenylephrine use can cause rebound nasal congestion due to vasoconstrictor overuse.
Identify potential drug-drug interactions that may occur with tamoxifen
- A. Not provided in document
- B. Not provided in document
- C. Not provided in document
- D. Not provided in document
Correct Answer: D
Rationale: This question lacks options in the document, but based on the answer key (ANS: 4), it is assumed to correspond to the fourth choice if options were present. Tamoxifen has significant interactions with CYP2D6 inhibitors (e.g., SSRIs), which can reduce its efficacy.
You are assigned to infuse 300 mL of a solution over 2 hours with a drop factor of 15 gtt/mL. What is the flow rate in drops per minute?
- A. 25 gtt/min
- B. 37.5 gtt/min
- C. 45 gtt/min
- D. 75 gtt/min
Correct Answer: B
Rationale: Flow rate = (300 mL 15 gtt/mL) ÷ (2 60) = 4,500 ÷ 120 = 37.5 gtt/min, exactly matching option B.
Which of the following would the nurse identify as a factor that alters drug response in children and infants? (Select one that does not apply.)
- A. Slower gastric emptying
- B. Greater surface area
- C. Less protein binding
- D. Decreased body water content
Correct Answer: D
Rationale: Children and infants are not small adults; therefore, they have altered pharmacokinetics. Factors that alter pharmacokinetics in children include slower gastric emptying, less cutaneous fat, greater surface area, increased body water content, less protein binding, and immature hepatic and renal function.