Nokea
The reason that two MMR vaccines at least a month apart are recommended is:
- A. The second dose of MMR 'boosts' the immunity built from the first dose
- B. Two vaccines 1 month apart is the standard dosing for all live virus vaccines
- C. If the two MMR vaccine doses are given too close together there is a greater likelihood of severe localized reaction to the vaccine
- D. Only 95% of patients are fully immunized for measles after the first vaccine, with 99% having immunity after two doses of MMR
Correct Answer: D
Rationale: Two MMR doses ensure 99% immunity, as 95% respond to one dose; boosting is secondary to this goal.
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A patient is being treated with isoniazid (INH), rifampin, and pyrazinamide in phase I of treatment for tuberculosis. The organism develops resistance to isoniazid. Which drug will the nurse anticipate the provider will order to replace the isoniazid?
- A. Ciprofloxacin (Cipro)
- B. Ethambutol (Myambutol)
- C. Kanamycin
- D. Streptomycin sulfate
Correct Answer: B
Rationale: Ethambutol replaces INH in phase I if resistance occurs; ciprofloxacin or kanamycin are less common first-line options. If there is bacterial resistance to isoniazid, the first phase may be changed to ethambutol, rifampin, and pyrazinamide.
Therapeutic index of a drug is an indicator of
- A. Potency
- B. Safety
- C. Toxicity
- D. Efficacy
Correct Answer: C
Rationale: Therapeutic index (TD50/ED50) measures the margin between therapeutic and toxic doses.
A community health nurse visits a client at home. Prednisone 10 mg orally daily has been prescribed for the client and the nurse reinforces teaching for the client about the medication. Which statement, if made by the client, indicates that further teaching is necessary?
- A. I can take aspirin or my antihistamine if I need it.'
- B. I need to take the medication every day at the same time.'
- C. I need to avoid coffee, tea, cola, and chocolate in my diet.'
- D. If I gain more than 5 pounds a week, I will call my doctor.'
Correct Answer: A
Rationale: Aspirin and other over-the-counter medications should not be taken unless the client consults with the health care provider (HCP). The client needs to take the medication at the same time every day and should be instructed not to stop the medication. A slight weight gain as a result of an improved appetite is expected, but after the dosage is stabilized, a weight gain of 5 lb or more weekly should be reported to the HCP. Caffeine-containing foods and fluids need to be avoided because they may contribute to steroid-ulcer development.
An elderly person has been prescribed lactulose for treatment of chronic constipation. Monitoring with long-term treatment would include:
- A. Electrolytes, including potassium and chloride
- B. Bone mineral density for osteoporosis
- C. Magnesium level
- D. Liver function
Correct Answer: A
Rationale: Lactulose can alter electrolytes (e.g., potassium) in the elderly; osteoporosis or magnesium aren't directly linked.
After completing a course on pharmacology for nurses, what will the nurse know?
- A. Everything necessary for safe and effective medication administration
- B. Current pharmacologic therapy; the nurse will not require ongoing education for 5 years.
- C. General drug information; the nurse can consult a drug guide for specific drug information.
- D. The drug actions that are associated with each classification of medication
Correct Answer: C
Rationale: After completing a pharmacology course nurses will have general drug information needed for safe and effective medication administration but will need to consult a drug guide for specific drug information before administering any medication. Pharmacology is constantly changing, with new drugs entering the market and new uses for existing drugs identified. Continuing education in pharmacology is essential to safe practice. Nurses tend to become familiar with the medications they administer most often, but there will always be a need to research new drugs and also those the nurse is not familiar with because no nurse knows all medications.