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The nurse is caring for a patient who had a severe, acute, previously unseen adverse effect of a drug in Phase III testing. The patient asks, After all the testing done on this drug, didnt they know this adverse effect could occur? What is the nurses best response? (Select all that apply.)
- A. Phase III testing involves wide-scale population testing, which can reveal rare adverse effects not seen in earlier phases.
- B. New adverse effects can lead to further study or withdrawal of the drug.
- C. Phase I testing on healthy volunteers ensures all adverse effects are identified before patient use.
- D. Even with extensive testing, some adverse effects may only appear after widespread use.
Correct Answer: C
Rationale: Phase III testing involves a large population, uncovering rare effects . Preclinical animal studies don't fully predict human responses (B is false). Phase I uses healthy volunteers, missing disease-specific effects (C is false). Rare effects emerge post-approval , potentially leading to further action .
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A nurse working in radiology administers iodine to a patient who is having a computerized axial tomography (CAT) scan. A nurse working on an oncology unit administers chemotherapy to patients who have cancer. At the Public Health Department, a nurse administers a measles-mumps-rubella (MMR) vaccine to a 14month-old child as a routine immunization. Which branch of pharmacology best describes the actions of all three nurses?
- A. Pharmacoeconomics
- B. Pharmacotherapeutics
- C. Pharmacodynamics
- D. Pharmacokinetics
Correct Answer: B
Rationale: Pharmacology is the study of the biologic effects of chemicals. Nurses are involved with clinical pharmacology or pharmacotherapeutics, which is a branch of pharmacology that deals with the uses of drugs to treat, prevent, and diagnose disease. The nurse working in radiology is administering a drug to help diagnose a disease. The nurse working on an oncology unit is administering a drug to help treat a disease. Pharmacoeconomics includes any costs involved in drug therapy. Pharmacodynamics involves how a drug affects the body, and pharmacokinetics is how the body acts on the drug.
When taking a medication history on a patient why should the nurse ask about the use of alternative therapies?
- A. Patients who use new drugs are usually not compliant with medical regimens.
- B. Many drug-alternative therapy interactions can cause serious problems and should be avoided.
- C. Natural products may be more effective and the drug may not be needed.
- D. The cost of the drug and the alternative therapy may be too great for the patient to handle.
Correct Answer: B
Rationale: Alternative therapies can interact with prescribed drugs, potentially causing adverse effects, making this a critical assessment point.
An order is written for oxazepam for a 6-year-old child. The nurse notices that there is no established dosage for children 6 to 12 years of age. Knowing that the usual adult dose is 10 mg t.i.d., what would the nurse calculate the appropriate dose to be?
- A. 0.03 mg t.i.d.
- B. 0.3 mg t.i.d.
- C. 1.8 mg t.i.d.
- D. 3.3 mg t.i.d.
Correct Answer: D
Rationale: Because the nurse only knows the child's age, the nurse would need to use Young's Rule to determine the appropriate dosage. Use the formula, child's dose equals the age of the child in years divided by the child's age plus 12 times the average adult dose to calculate the answer. Dose = (6/[6+12]) 10 mg (6/18 = 0.33 10 = 3.3).
Km value indicates
- A. Purity of enzyme
- B. Physiological role
- C. Half life enzyme drug complex
- D. Affinity
Correct Answer: C
Rationale: Km (Michaelis constant) reflects the substrate concentration at half-maximum velocity, indicating enzyme-drug complex half-life.
A patient arrives at the health care clinic and informs the nurse that he has consumed several aspirin tablets for a severe headache over the past 24 hours. The nurse would be alert for which of the following as a harmful effect?
- A. Gastrointestinal bleeding
- B. Breathing difficulties
- C. Visual disturbances
- D. Loss of balance
Correct Answer: A
Rationale: Aspirin is potentially harmful and can cause gastrointestinal bleeding and salicylism. Breathing difficulties, visual disturbances, and loss of balance could be due to an illness or the effects of some other drug.