Nokea
The nursing instructor is discussing drug therapy in the older adult. What would the instructor tell the students about what could affect therapeutic dosing in an older adult?
- A. Changes in the gastrointestinal (GI) system can reduce drug absorption.
- B. In older adults, drugs enter into circulation more quickly.
- C. In older adults, drugs are distributed to a smaller portion of the tissues.
- D. In older adults, drugs have an increased action
Correct Answer: A
Rationale: GI changes in aging (e.g., reduced motility) decrease absorption, affecting dosing.
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The client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication?
- A. Glucose level
- B. Calcium level
- C. Potassium level
- D. Prothrombin time
Correct Answer: B
Rationale: Tamoxifen may increase calcium, cholesterol, and triglyceride levels. Before the initiation of therapy, a complete blood count, platelet count, and serum calcium levels should be assessed. These blood levels, along with cholesterol and triglyceride levels, should be monitored periodically during therapy. The nurse should assess for hypercalcemia while the client is taking this medication. Signs of hypercalcemia include increased urine volume, excessive thirst, nausea, vomiting, constipation, hypotonicity of muscles, and deep bone and flank pain.
The nursing assessment identifies that the client is nauseated and cannot take acetaminophen (Tylenol) orally. Which is true regarding the substitution of this medication to suppository form?
- A. It is standard practice when the patient is unable to take the ordered medication.
- B. It is acceptable if the patient agrees to the altered route form.
- C. It is preferable to having the patient miss a dose of the medication.
- D. It is contraindicated without an order from the health care provider.
Correct Answer: D
Rationale: One dosage form of medication should never be substituted for another unless the prescriber is consulted; there can be a great variation in the absorption rate of the medication through different routes of administration. The substitution of one form for another is not standard practice, and is not acceptable or preferable without the prescriber's order.
Antacids such as calcium carbonate (Tums) can reduce the absorption of which of the following nutrients?
- A. Protein
- B. Calcium
- C. Iron
- D. Vitamin K
Correct Answer: C
Rationale: Calcium carbonate binds to iron, forming insoluble complexes that reduce iron absorption.
Which of the following glucocorticosteroids are used for cerebral oedema:
- A. Triamcinolon
- B. Prednisolon
- C. Prednison
- D. Dexamethasone
Correct Answer: D
Rationale: Dexamethasone is favored for cerebral edema due to its strong anti-inflammatory properties and low mineralocorticoid activity.
A nurse is caring for a client who has Depression and a new prescription for Venlafaxine. For which of the following adverse effects should the nurse monitor this client? (Select all that apply)
- A. Cough
- B. Dizziness
- C. Increased libido
- D. Invention
Correct Answer: B
Rationale: Venlafaxine can cause dizziness , decreased libido , and hypotension ; 'invention' seems a typo.