The type of adverse drug reaction that is idiosyncratic when a drug given in the usual therapeutic doses is type:
- A. A
- B. B
- C. C
- D. D
Correct Answer: B
Rationale: Type B reactions are idiosyncratic, unpredictable responses to normal doses, unlike dose-related Type A or chronic Type C/D.
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A nurse is preparing a teaching plan for a female client who has Bipolar disorder and a new prescription for Carbamazepine. Which of the following instructions should the nurse include in the teaching? (Select one that does not apply.)
- A. This medication can safely be taken during pregnancy.
- B. Eliminate grapefruit juice from your diet.
- C. You will need to have a complete blood count and carbamazepine levels drawn periodically.
- D. You'll your provider if you develop a rash.
Correct Answer: A
Rationale: Grapefruit juice interacts, blood counts monitor toxicity, rash signals reaction, and driving caution addresses sedation.
The adverse events of biguanides are:
- A. Alkalosis
- B. Hypoxemia/acidosis
- C. Weight loss
- D. Anemia
Correct Answer: B
Rationale: Biguanides like metformin can cause lactic acidosis, a serious adverse effect related to impaired mitochondrial function.
The patient looks at the prescription provided by the doctor and asks the nurse whether he can request a generic substitution. The nurse answers No when noting what on the prescription?
- A. No refills
- B. DAW
- C. Brand name used on prescription
- D. Patient older than 65 years of age
Correct Answer: B
Rationale: DAW stands for dispense as written and means that the doctor does not want a generic substituted for the prescribed medication. Requesting no refills does not preclude the substitution of a generic medication. Even when the brand name is ordered, the pharmacist can substitute a generic equivalent so long as the prescriber does not write DAW. Generic substitutions are not impacted by the patient's age.
A 35-year-old male patient is admitted to the hospital with pneumonia. He was originally being treated at home, but became worse when he quit taking his antibiotic prematurely. What is an appropriate nursing diagnosis for this patient?
- A. Deficient knowledge: monitoring temperature
- B. Noncompliance
- C. Risk for injury related to hypoxia
- D. Non-adherence: overuse
Correct Answer: B
Rationale: Stopping antibiotics early indicates noncompliance, worsening his condition.
You are caring for a patient who takes several drugs. You know that those patients most likely to have adverse drug reactions are who?
- A. Patients with coronary artery disease
- B. Non-compliant patients
- C. Patients who are on the recommended dose
- D. Very young and very old patients
Correct Answer: D
Rationale: Very young and old patients have immature or declining organ function, increasing adverse reaction risk.