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The nurse receives an order to administer an unfamiliar medication and obtains a nurses drug guide published four years earlier. What is the nurses most prudent action?
- A. Find a more recent reference source.
- B. Use the guide if the drug is listed.
- C. Ask another nurse for drug information.
- D. Verify the information in the guide with the pharmacist.
Correct Answer: A
Rationale: The nurse is responsible for all medications administered and must find a recent reference source to ensure the information learned about the medication is correct and current. Using an older drug guide could be dangerous because it would not contain the most up-to-date information. Asking another nurse or the pharmacist does not guarantee accurate information will be obtained and could harm the patient if the information is wrong.
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The use of information technology for quality improvement in pharmacotherapeutics includes:
- A. Incorporating the use of 'apps' into all patient encounters
- B. Tracking data trends within the practice via the electronic health record database
- C. Informing patients that they have access to their medication list via the Internet
- D. Using macros for individualizing patient care management
Correct Answer: B
Rationale: Tracking data trends in EHRs supports quality improvement in pharmacotherapeutics.
An important concept taught by the nurse when providing medication teaching is the need to provide a complete list of medications taken to health care providers to avoid what?
- A. Spending large amounts of money on medications
- B. Allergic reactions to medications
- C. Drug-drug interactions
- D. Critical concentrations of medications in the body
Correct Answer: C
Rationale: It is important that all health care providers have a complete list of the patient's medications to avoid drug-drug interactions caused by one provider ordering a medication, unaware of another medication the patient is taking that could interact with the new prescription. Using the same pharmacist for all prescriptions will also help to prevent this from happening. Informing the provider of all medications taken will not reduce costs of medications, which is best accomplished by requesting generic medications. Allergies should be disclosed to all health care providers as well, but this is not why it is important to provide a complete list of medications taken. Critical concentrations are desirable because that is the amount of drug needed to cause a therapeutic effect, or, in other words, to have the effect the drug is prescribed for.
The clinic nurse is performing an admission assessment on a client. The nurse notes that the client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the client is being treated for:
- A. Acne
- B. Eczema
- C. Hair loss
- D. Herpes simplex
Correct Answer: A
Rationale: Azelaic acid is a topical medication used to treat mild to moderate acne. The acid appears to work by suppressing the growth of Propionibacterium acnes and decreasing the proliferation of keratinocytes. Options 2, 3, and 4 are incorrect.
The patient, diagnosed with cancer, is receiving morphine sulfate (a potent narcotic pain reliever) to relieve cancer pain. Approximately every 7 days the medication is no longer effective in controlling the patient's pain and a larger dose is needed to have the same effect. How might the nurse explain why this is happening?
- A. Tolerance
- B. Cumulation
- C. Interactions
- D. Addiction
Correct Answer: A
Rationale: The body may develop a tolerance to some drugs over time. Tolerance may arise because of increased biotransformation of the drug, increased resistance to its effects, or other pharmacokinetic factors. When tolerance occurs, the amount of the drug no longer causes the same reaction. Therefore, increasingly larger doses are needed to achieve a therapeutic effect. Cumulative effect occurs when the drug is not properly eliminated and more of the drug is administered, resulting in toxic levels accumulating. Interactions occur when the drug reacts badly with another substance such as food, another drug, or an alternative or complementary therapy. Addiction is the psychological need for a substance.
Under new U.S. Food and Drug Administration labeling, Pregnancy Categories will be:
- A. Strengthened with a new coding such as C+ or C- to discern when a drug is more or less toxic to the fetus
- B. Changed to incorporate a pregnancy risk summary and clinical considerations on the drug label
- C. Eliminated, and replaced with a link to the National Library of Medicine TOXNET Web site for in-depth information regarding pregnancy concerns
- D. Clarified to include information such as safe dosages in each trimester of pregnancy
Correct Answer: B
Rationale: FDA replaced categories with risk summaries and clinical considerations for clearer, narrative-based guidance, effective 2015.