Nokea
The nurse caring for a patient who has tuberculosis and who is taking isoniazid, rifampin, and streptomycin reviews the medical record and notes the patient's sputum cultures reveal resistance to streptomycin. The nurse will anticipate that the provider will take which action?
- A. Add ethambutol (Myambutol)
- B. Change the streptomycin to clarithromycin
- C. Change the streptomycin to kanamycin
- D. Order renal function tests
Correct Answer: C
Rationale: Kanamycin replaces streptomycin in phase I resistance; ethambutol is for INH resistance, and clarithromycin is phase II. The patient's current regimen is first-phase treatment. If resistance to streptomycin develops, the provider can change to kanamycin or to ciprofloxacin.
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Which of the following is a primary benefit of the use of computerized provider order entry for patient medications?
- A. Reduces time that prescribing drugs takes
- B. Eliminates the need to chart drugs prescribed
- C. Decreases prescribing and transcription errors
- D. Helps keep the number of drugs prescribed to a minimum
Correct Answer: C
Rationale: Computerized provider order entry reduces errors in prescribing and transcription.
When involved in phase III drug evaluation studies, what responsibilities would the nurse have?
- A. Working with animals who are given experimental drugs
- B. Choosing appropriate patients to be involved in the drug study
- C. Monitoring and observing patients closely for adverse effects
- D. Conducting research to determine effectiveness of the drug
Correct Answer: C
Rationale: Phase III studies involve use of a drug in a vast clinical population in which patients are asked to record any symptoms they experience while taking the drugs. Nurses may be responsible for helping collect and analyze the information to be shared with the Food and Drug Administration (FDA) but would not conduct research independently because nurses do not prescribe medications. Use of animals in drug testing is done in the preclinical trials. Select patients who are involved in phase II studies to participate in studies where the participants have the disease the drug is intended to treat. These patients are monitored closely for drug action and adverse effects. Phase I studies involve healthy human volunteers who are usually paid for their participation. Nurses may observe for adverse effects and toxicity.
A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about a potential contraindication to a medication for which of the following clients?
- A. A client at 8 weeks of gestation who asks for an influenza immunization
- B. A client who takes Prednisolone and has a no fungal infection
- C. A client who has chronic liver disease and is taking hydrocortone
- D. A client who has Peptic Ulcer Disease, takes Sucralfate, and tells the nurse she has started taking OTC Aluminum Hydroxide
Correct Answer: C
Rationale: Prednisolone worsens fungal infections, hydrocortisone is risky in liver disease, and warfarin with pregnancy increases bleeding risk.
A 57-year-old man was recently diagnosed with Type-2 diabetes mellitus and placed on a medication. He began having myalgias and feeling sick and later developed respiratory distress, so he went to the hospital. His pH was 7.2, and he had elevated blood lactate levels. Which drug is likely causing his problem?
- A. Acarbose
- B. Glyburide
- C. Metformin
- D. Pioglitazone
Correct Answer: C
Rationale: Metformin can cause lactic acidosis, a rare but serious side effect, presenting with low pH and elevated lactate levels.
A nurse is assessing a client who is taking Amiodarone to treat Atrial Fibrillation. Which of the following findings is a manifestation of Amiodarone toxicity?
- A. Light yellow urine
- B. Report of tinnitus
- C. Productive cough
- D. Blue-gray skin discoloration
Correct Answer: C
Rationale: Productive cough may indicate pulmonary toxicity, a serious amiodarone side effect.