Nokea
The nurse is working with the family whose child is taking atomoxetine for ADHD. Which instructions should the nurse include when teaching the parents? Select all that apply.
- A. Provide stimulation because atomoxetine causes sedation.
- B. Administer atomoxetine immediately after eating a meal.
- C. Administer atomoxetine at least 6 hours before bedtime.
- D. Weigh the child weekly to monitor for unintended weight loss.
- E. Consult with the prescriber before giving cold or allergy medication.
Correct Answer: B,C,D,E
Rationale: Atomoxetine (Strattera) should be taken after meals, at least 6 hours before bedtime, with weekly weight monitoring and caution with OTC medications.
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The factor that most determines drug distribution is:
- A. vascular perfusion of the tissue or organ.
- B. salt form.
- C. drug interactions.
- D. steady state.
Correct Answer: A
Rationale: Drugs are distributed via the circulatory system. Adequate perfusion is necessary for distribution of a drug. The other choices are not as dependent on adequate perfusion.
The initial treatment regimen of isoniazid, rifampin, and ethambutol is prescribed for the adolescent who has a positive tuberculin skin test. The client confides that she thinks she may be pregnant and asks if she should be taking these medications. Which rationale should be the basis for the nurse's response?
- A. These drugs cross the placental barrier, and treatment should be withheld until the postpartum period.
- B. The medications should be taken, but the diagnosis is an indication for termination of the pregnancy.
- C. The medications should be postponed because the risk for hepatitis is greatly increased in the intrapartum period.
- D. The medications should be taken; untreated TB represents a far greater hazard to the pregnant woman and her fetus.
Correct Answer: D
Rationale: A: The medications do not cross the placental barrier, so treatment should not be withheld. B: Administering antituberculosis medications would not be an indication for termination of pregnancy because the medications are safe during pregnancy. C: The risk of hepatitis is slightly increased with the use of antituberculosis medications in pregnant women; however, the benefits of treatment strongly outweigh postponement of treatment. D: Infants born to women with untreated TB may be of lower birth weight, but rarely would the infant acquire congenital TB. Isoniazid (Nydrazid), rifampin (Rifadin), and ethambutol (Myambutol) are all considered safe for use in pregnancy.
Which spot is the safest place to administer an IM injection to an infant? Select the correct corresponding letter from the attached graphic.
- A. C
- B. B
- C. A
- D. D
Correct Answer: B
Rationale: The vastus lateralis muscle, highlighted by the letter B, should be used in infants as the muscle tends to be thickest in this area.
The 40-year-old client is receiving levothyroxine for treatment of hypothyroidism. Which serum laboratory results should lead the nurse to conclude that the client's dose is adequate?
- A. Thyroid-stimulating hormone and cortisol
- B. Thyroid-stimulating hormone and free T4
- C. Triiodothyronine (T3) and free thyroxine (T4)
- D. White blood cells, glucose, and potassium
Correct Answer: B
Rationale: A: Cortisol levels are used to evaluate adrenal and not thyroid function. B: Restoration of normal laboratory values for TSH and free T4 indicates that the dose of levothyroxine (Synthroid) is therapeutic. C: T3 is used to evaluate the effectiveness of liothyronine and propylthiouracil, used in the treatment of thyroid disorders. D: The WBC count is used to determine if the client has an infection. Evaluation of serum glucose and potassium levels is unrelated to the use of levothyroxine.
The child is to start on medication therapy for enuresis that has not resolved with behavioral interventions. Which medication should the nurse anticipate being prescribed for the child?
- A. Lorazepam
- B. Desmopressin
- C. Nitrofurantoin
- D. Spironolactone
Correct Answer: B
Rationale: A: Lorazepam (Ativan) is a benzodiazepine used to treat anxiety. A side effect is drowsiness, which could impair a child's ability to waken for voiding. B: Desmopressin (DDAVP) is an analog of arginine vasopressin, which acts as an antidiuretic. It promotes resorption of water in the renal tubule or decreases bladder filling. C: Nitrofurantoin (Macrobid) is a urinary tract antiseptic used to treat UTIs and would not be used with enuresis. D: Spironolactone (Aldactone) is a potassium-sparing diuretic that would promote, not inhibit, diuresis.