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The patient is a 6-year-old child who is taking 125 mg of amoxicillin every 6 hours. Assuming that the half-life of Amoxicillin is 3 hours, how much Amoxicillin would be in the child's body at the time of the next administration of the drug?
- A. 62.5 mg
- B. 46.875 mg
- C. 31.25 mg
- D. 15.625 mg
Correct Answer: C
Rationale: The half-life of a drug is the time it takes for the amount of drug in the body to decrease to 1 half the peak level it previously achieved. Option A would occur at 3 hours after the original dose of amoxicillin. Option B would occur 4½ hours after the original dose. Option C would occur at 6 hours after the original dose. Option D would occur at 7½ hours after the original dose.
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What must the nurse have before administering any medication? (Select one that does not apply.)
- A. A current license to practice
- B. A medication order signed by a practitioner licensed with prescription privileges
- C. Knowledge of the medication
- D. Consultation with a pharmacist
Correct Answer: D
Rationale: Physicians must be licensed to prescribe medications; nurses must be licensed to administer medications. Safe medication administration includes knowledge of the medication, pathophysiology of patient diagnoses, and pharmacodynamics of the ordered medication on the pathophysiology. It is not necessary for the nurse to consult with a pharmacist each time medication is to be administered to a patient.
A nurse is caring for a patient who has recently moved from Vermont to south Florida. The patient has been on the same antihypertensive drug for 6 years and has had stable blood pressures and no side effects. Since her move, however, she reports having 'dizzy spells and weakness' and feels that the drug is no longer effective. The nurse knows that one possible reason for the change in the effectiveness of the drug could be which of the following?
- A. The impact of the placebo effect on the patient's response
- B. The accumulative effect of the drug if it has been taken for many years
- C. The impact of the warmer environment on the patient's physical state
- D. Problems with patient compliance with the drug regimen while on vacation
Correct Answer: C
Rationale: Antihypertensive drugs work to decrease the blood pressure. When a patient goes to a climate that is much warmer than usual, blood vessels dilate and the blood pressure falls. If a patient is taking an antihypertensive drug and enters a warmer climate, there is a chance that the patient's blood pressure will drop too low, resulting in dizziness and feelings of weakness. Most antihypertensives are metabolized and excreted and do not accumulate in the body. Patients must be very compliant with their drug regimen while on vacation. After several years on an antihypertensive drug, the effects of that drug are known; therefore, the placebo effect should not be an issue.
The patient asks the nurse why generic drugs would be used and voices concerns that only the brand name product will be safe. What is the nurse's best response?
- A. Generic drugs are often less expensive.
- B. Some quality control problems have been found with generic drugs.
- C. Most generic drugs are very safe and can be cost effective as well.
- D. Although initial cost is higher for a brand name it may cost less in the long run.
Correct Answer: C
Rationale: Most generic medications are completely safe and may be identical to the brand name drug except generic medications are often less expensive, but this does not address the patient's concern about safety. Although some quality control issues have occurred in the past, this does not address the patient's concerns regarding safety or explain why generic drugs are prescribed and used. Although some doctors believe initial cost is higher but will cost less over time, this response also does not address the patient's concerns.
Vitamin B2 (riboflavin) may be prescribed to:
- A. Decrease the incidence of beriberi
- B. Reduce headaches and migraines
- C. Prevent pernicious anemia
- D. Treat hyperlipidemia
Correct Answer: B
Rationale: Riboflavin has been used to reduce migraine frequency, though evidence is limited.
The nurse is reviewing the patient's admission medication orders. What order would the nurse to question?
- A. Digoxin .5 mg orally now give one dose only
- B. Lasix 20 mg. IV every 4 hours times 3
- C. Gentamicin 80 mg IV to infuse over 1 hour every 12 hours
- D. Acetaminophen 650 mg PO every 4 hours as needed for pain
Correct Answer: A
Rationale: Digoxin .5 mg (0.5 mg) is a high initial dose; typical is 0.125-0.25 mg, requiring clarification.