Nokea
The nurse is administering drugs to neonates and will consider which factor may contribute the most to drug toxicity?
- A. The lungs are immature.
- B. The kidneys are small.
- C. The liver is not fully developed.
- D. Excretion of the drug occurs quickly.
Correct Answer: C
Rationale: A neonate's liver is not fully developed and cannot detoxify many drugs, contributing most to drug toxicity. Immature lungs and small kidneys play lesser roles, and excretion is slow, not fast, due to organ immaturity.
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The nurse is preparing to give an injection to a 4-year-old child. Which intervention is age appropriate for this child?
- A. Give the injection without any advanced preparation.
- B. Give the injection, and then explain the reason for the procedure afterward.
- C. Offer a brief, concrete explanation of the procedure at the patient's level and with the parent or caregiver present.
- D. Prepare the child in advance with details about the procedure without the parent or caregiver present.
Correct Answer: C
Rationale: For a 4-year-old child, offering a brief, concrete explanation about a procedure just beforehand, with the parent or caregiver present, is appropriate. No preparation, explaining afterward, or preparing without a parent are not age-appropriate interventions.
An 83-year-old woman has been given a thiazide diuretic to treat heart failure. She and her caregiver should be told to watch for which problems?
- A. Constipation and anorexia
- B. Fatigue, leg cramps, and dehydration
- C. Daytime sedation and lethargy
- D. Edema, nausea, and blurred vision
Correct Answer: B
Rationale: Electrolyte imbalance, leg cramps, fatigue, and dehydration are common complications when thiazide diuretics are given to elderly patients. The other options do not describe typical complications associated with thiazide diuretics in the elderly.
The nurse is assessing a newly admitted 83-year-old patient and determines that the patient is experiencing polypharmacy. Which statement most accurately illustrates polypharmacy?
- A. The patient is experiencing multiple illnesses.
- B. The patient uses one medication for an illness several times per day.
- C. The patient uses over-the-counter drugs for an illness.
- D. The patient uses multiple medications simultaneously.
Correct Answer: D
Rationale: Polypharmacy usually occurs when a patient has several illnesses and takes medications for each of them, possibly prescribed by different specialists who may be unaware of other treatments the patient is undergoing. It involves multiple medications, not just multiple illnesses, a single medication, or only over-the-counter drugs.
An elderly patient with a new diagnosis of hypertension will be receiving a new prescription for an antihypertensive drug. The nurse expects which type of dosing to occur with this drug therapy?
- A. Drug therapy will be based on the patient's weight.
- B. Drug therapy will be based on the patient's age.
- C. The patient will receive the maximum dose that is expected to reduce the blood pressure.
- D. The patient will receive the lowest possible dose at first, and then the dose will be increased as needed.
Correct Answer: D
Rationale: As a general rule, dosing for elderly patients should follow the principle of 'start low, and go slow,' meaning start with the lowest possible dose and increase slowly if needed, based on patient response. Dosing is not primarily based on weight or age, and maximum doses are not initially given.
Drug transfer to the fetus is more likely during the last trimester of pregnancy for which reason?
- A. Decreased fetal surface area
- B. Increased placental surface area
- C. Enhanced blood flow to the fetus
- D. Increased amount of protein-bound drug in maternal circulation
Correct Answer: C
Rationale: Drug transfer to the fetus is more likely during the last trimester of pregnancy as a result of enhanced blood flow to the fetus. Increased fetal surface area, not decreased, is a factor that affects drug transfer to the fetus. The placenta's surface area does not increase during this time. Drug transfer is increased because of an increased amount of free drug, not protein-bound drug, in the mother's circulation.