Nokea
The nurse is preparing a medication that is new to the market and cannot be found in the nurses drug guide. Where can the nurse get the most reliable information about this medication?
- A. Package insert
- B. Another nurse
- C. Drug manufacturer
- D. Physician
Correct Answer: A
Rationale: The most reliable information about the drug can be found on the package insert supplied by the manufacturer because it was prepared according to strict Food and Drug Administration (FDA) regulations. Asking another nurse or the physician is not reliable and cannot be verified as accurate. It would not be realistic to call the drug manufacturer for information.
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What concept is considered when generic drugs are substituted for brand name drugs?
- A. Bioavailability
- B. Critical concentration
- C. Distribution
- D. Half-life
Correct Answer: A
Rationale: Bioavailability is the portion of a dose of a drug that reaches the systemic circulation and is available to act on body cells. Binders used in a generic drug may not be the same as those used in the brand name drug. Therefore, the way the body breaks down and uses the drug may differ, which may eliminate a generic drug substitution. Critical concentration is the amount of a drug that is needed to cause a therapeutic effect and should not differ between generic and brand name medications. Distribution is the phase of pharmacokinetics, which involves the movement of a drug to the body's tissues and is the same in generic and brand name drugs. A drug's half-life is the time it takes for the amount of drug to decrease to half the peak level, which should not change when substituting a generic medication.
Suzanne is started on paroxetine (Paxil), a selective serotonin reuptake inhibitor (SSRI), for depression. Education regarding her antidepressant includes:
- A. SSRIs may take 2 to 6 weeks before she will have maximum drug effects.
- B. Red-green color blindness may occur and should be reported.
- C. If she experiences dry mouth or heart rates greater than 80, she should stop taking the drug immediately.
- D. She should eat lots of food high in fiber to prevent constipation.
Correct Answer: A
Rationale: SSRIs require 2-6 weeks for full effect, a key patient education point.
Prior to administering a prescribed drug, the nurse correctly identifies the client by which method?
- A. Checking a client's name on his or her wristband
- B. Checking a client's chart
- C. Asking the client if the are Mr. Jones
- D. Asking a client if he or she is the correct client
Correct Answer: A
Rationale: Client identifiers can include visual and verbal methods. Visual methods include use of a recent picture of the client or client wristband. Verbal methods include asking the client for his or her name and another unique identifier, such as his or her birth date. Never ask a client, 'Are you Mr. Jones?' because some clients may respond by answering 'yes' even though that is not their name due to confusion or difficulty hearing. Checking the client's chart would be inappropriate to use for identifying the client.
The 'donut hole' in Medicare Part D:
- A. Will be totally eliminated with the federal health-care reform enacted in 2010
- B. Refers to the period of time when annual individual drug costs are between 250 and 2,250 per year and drug costs are covered 75%
- C. Refers to the period between when the annual individual drug costs are 2,970 and 4,750 and the patient pays 52.5% of the costs of brand name drugs (2013)
- D. Has no effect on whether patients continue to fill their prescriptions during the coverage gap
Correct Answer: C
Rationale: The donut hole (2013) is the coverage gap where patients pay more out-of-pocket.
Pregnant patients who are taking isoniazid (INH) should take 25 mg/day of vitamin B6 (pyridoxine) to prevent:
- A. Beriberi
- B. Peripheral neuropathy
- C. Rickets
- D. Megaloblastic anemia
Correct Answer: B
Rationale: Vitamin B6 supplementation prevents INH-induced peripheral neuropathy.