Nokea
The nurse is discussing smoking cessation with a nurse colleague who smokes. Which statement indicates a readiness to quit smoking?
- A. I don't smoke around my children or inside the house
- B. I want to stop smoking, but I will need help to do it
- C. I will quit so my co-workers will stop harassing me about it
- D. If I cut down gradually, I should be able to quit
Correct Answer: B
Rationale: Readiness shows intent and help-seeking; external pressure or gradual cutdown don't confirm it. Patients exhibit readiness when they state a desire to quit along with a request for professional assistance.
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When the costs of a specific treatment or intervention are calculated and then compared with the dollar value of the benefit received it is referred to as:
- A. Cost-minimization analysis
- B. Cost-of-illness analysis
- C. Cost-effectiveness analysis
- D. Cost-benefit analysis
Correct Answer: D
Rationale: Cost-benefit analysis quantifies both costs and benefits in monetary terms.
A patient's liquid cough medicine has been discontinued with one half of the bottle remaining. The home health nurse is aware that according to the U.S. Food and Drug Administration (FDA) guidelines on prescription medication disposal, the next step should be to:
- A. save the remainder for another patient with the same prescription.
- B. flush the remainder down the toilet.
- C. read the drug label for specific disposal instructions.
- D. pour remaining medication into a hazardous waste container.
Correct Answer: C
Rationale: The nurse must follow specific disposal instructions on the drug label or in the patient information leaflet that accompanies the medication. Prescription medications should not be shared among patients. Prescription drugs should not be flushed down the toilet unless specifically instructed to do so by the manufacturer. The first action to be taken is to follow disposal instructions on the label. If the drug label indicates it should be emptied into a hazardous waste container, measures should be taken to prevent leaking and/or accidental ingestion.
Josie is a 5-year-old patient who presents to the clinic with a 48-hour history of nausea, vomiting, and some diarrhea. She is unable to keep fluids down and her weight is 4 pounds less than her last recorded weight. Besides IV fluids, her exam warrants the use of an antinausea medication. Which of the following would be the appropriate drug to order for Josie?
- A. Prochlorperazine (Compazine)
- B. Meclizine (Antivert)
- C. Promethazine (Phenergan)
- D. Ondansetron (Zofran)
Correct Answer: D
Rationale: Ondansetron is preferred in kids for nausea/vomiting, with fewer side effects than prochlorperazine or promethazine ; meclizine is for motion sickness.
What is the role of calcium supplements when patients take bisphosphonates?
- A. They must be restricted to allow the medication to work
- B. They must be taken in sufficient amounts to provide foundational elements for bone growth
- C. They must be taken at the same time as the bisphosphonates
- D. They only work with bisphosphonates if daily intake is restricted
Correct Answer: B
Rationale: Calcium supports bone health with bisphosphonates but must be timed separately (not C) to avoid interference.
Laboratory monitoring for patients on angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers should include:
- A. White blood cell counts with the drug dosage increased for elevations above 10,000 feet
- B. Liver function tests with the drug dosage stopped for alanine aminotransferase values twice that of normal
- C. Serum creatinine levels with the drug dosage reduced for values greater than 2.5 mg/dL
- D. Serum glucose levels with the drug dosage increased for levels greater than 120 mg/dL
Correct Answer: C
Rationale: Elevated creatinine (>2.5 mg/dL) indicates renal impairment, requiring dose adjustment.