The therapeutic goals when prescribing include(s):
- A. Curative
- B. Palliative
- C. Preventive
- D. All of the above
Correct Answer: D
Rationale: Therapeutic goals can be curative, palliative, or preventive , depending on the patient's condition and needs.
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The nurse caring for a patient who has tuberculosis and who is taking isoniazid, rifampin, and streptomycin reviews the medical record and notes the patient's sputum cultures reveal resistance to streptomycin. The nurse will anticipate that the provider will take which action?
- A. Add ethambutol (Myambutol)
- B. Change the streptomycin to clarithromycin
- C. Change the streptomycin to kanamycin
- D. Order renal function tests
Correct Answer: C
Rationale: Kanamycin replaces streptomycin in phase I resistance; ethambutol is for INH resistance, and clarithromycin is phase II. The patient's current regimen is first-phase treatment. If resistance to streptomycin develops, the provider can change to kanamycin or to ciprofloxacin.
Scopolamine can be used to prevent the nausea and vomiting associated with motion sickness. The patient is taught to:
- A. Apply the transdermal disk at least 4 hours before the antiemetic effect is desired.
- B. Swallow the tablet 1 hour before traveling where motion sickness is possible.
- C. Place the tablet under the tongue and allow it to dissolve.
- D. Change the transdermal disk daily for maximal effect.
Correct Answer: A
Rationale: Scopolamine patches require 4 hours for onset, making preemptive application key.
The nurse would expect to see an adjusted dosage in what patients? (Select one that does not apply.)
- A. Young adult women
- B. older adults
- C. Infants
- D. Neonates
Correct Answer: A
Rationale: Infants, neonates, and older adults require dosage adjustments due to differences in metabolism and organ function.
A 57-year-old man was recently diagnosed with Type-2 diabetes mellitus and placed on a medication. He began having myalgias and feeling sick and later developed respiratory distress, so he went to the hospital. His pH was 7.2, and he had elevated blood lactate levels. Which drug is likely causing his problem?
- A. Acarbose
- B. Glyburide
- C. Metformin
- D. Pioglitazone
Correct Answer: C
Rationale: Metformin can cause lactic acidosis, a rare but serious side effect, presenting with low pH and elevated lactate levels.
Ototoxicity is more likely if aminoglycosides are administered with which of the following drug classes?
- A. Loop diuretics
- B. Metformin
- C. Vancomycin
- D. Cephalosporins
Correct Answer: A
Rationale: Loop diuretics (e.g., furosemide) enhance aminoglycoside ototoxicity by increasing inner ear damage risk.
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