Nokea
The nurse is preparing to administer an intravenous polymyxin antibiotic. The patient reports dizziness along with numbness and tingling of the hands and feet. The nurse will perform which action?
- A. Administer the drug since these are harmless side effects
- B. Hold the drug and notify the provider of these adverse reactions
- C. Obtain an order for an oral form of this medication
- D. Request an order for serum electrolytes
Correct Answer: B
Rationale: Polymyxin neurotoxicity (dizziness, numbness) warrants holding and reporting; these aren't harmless , and it's not oral . Polymyxins can cause nephrotoxicity and neurotoxicity.
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Which of the following is corresponding to the following statement: this drug is used for diabetes mellitus and while using there is an increased risk of pancreatitis:
- A. Miglitol
- B. Pioglitazon
- C. Exenatide
- D. Glimepiride
Correct Answer: C
Rationale: Exenatide, a GLP-1 agonist, treats diabetes and has a known risk of pancreatitis as a rare but serious side effect.
Choose a drug that is used for both non-Hodgkin's lymphoma and rheumatoid arthritis:
- A. Doxorubicin
- B. Vincristine
- C. Infliximab
- D. Rituximab
Correct Answer: D
Rationale: Rituximab targets CD20 in lymphoma and is also used in rheumatoid arthritis.
Before prescribing phentermine to Sarah, a thorough drug history should be taken including assessing for the use of serotonergic agents such as selective serotonin reuptake inhibitors (SSRIs) and St John's wort due to:
- A. Additive respiratory depression risk
- B. Additive effects affecting liver function
- C. The risk of serotonin syndrome
- D. The risk of altered cognitive functioning
Correct Answer: C
Rationale: Phentermine with serotonergic agents increases serotonin syndrome risk.
What would the nurse provide when preparing a patient for discharge and home medication self-administration?
- A. Personal contact information to use if the patient has questions
- B. Thorough medication teaching about drugs and the drug regimen
- C. Over-the-counter medications to use to treat potential adverse effects
- D. A sample size package of medication to take home until prescription is filled
Correct Answer: B
Rationale: The nurse is responsible for providing thorough medication teaching about drugs and the drug regimen to ensure the patient knows how to take the medication and when to notify the provider. The nurse never provides personal contact information to a patient. If adverse effects arise, the patient is taught to call the health care provider and should not self-medicate with over-the-counter drugs, which could mask serious symptoms. The nurse never dispenses medication because it must be properly labeled for home use; this is done by the pharmacy.
While administering a medication that the nurse has researched and found to have limited effectiveness, the patient tells the nurse, I have read all about this drug and it is such a wonder drug. I'm so lucky my doctor prescribed it because I just know it will treat my problem. The nurse suspects this drug will be more effective than usual for this patient because of what effect?
- A. Cumulative effect
- B. First-pass effect
- C. Placebo effect
- D. Cross-tolerance effect
Correct Answer: C
Rationale: A drug is more likely to be effective if the patient thinks it will work than if the patient believes it will not work. This is called the placebo effect. If a drug is taken in successive doses at intervals that are shorter than recommended, or if the body is unable to eliminate a drug properly, the drug can accumulate in the body, leading to toxic levels and adverse effects. This is a cumulative effect. First-pass effect addresses the reduction of available drug when taken orally due to metabolism in the liver before the drug reaches the bloodstream. Cross-tolerance is resistance to drugs within the same class.