Nokea
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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What dermatological issue is linked to Amiodarone use?
- A. Increased risk of basal cell carcinoma
- B. Flare up of any prior psoriasis problems
- C. Development of plantarwarts
- D. Progressive change of skin tone toward a blue spectrum
Correct Answer: D
Rationale: Amiodarone causes blue-gray skin discoloration due to drug deposition.
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.
Who defines the standards of care for the practice of nursing? (Select one that does not apply.)
- A. State boards of nursing
- B. Hospital policy and procedures
- C. Federal laws regulating health care facilities
- D. The Joint Commission
Correct Answer: B
Rationale: Standards of care are defined by state boards of nursing, federal laws regulating health care facilities, The Joint Commission, and professional nursing associations such as the American Nurses Association. Individual hospital policies and procedures incorporate federal and state guidelines into their respective policies and procedures and are often more stringent than state and federal regulations.
Patients need to be instructed regarding the drug interactions with St John's wort, including:
- A. MAO inhibitors
- B. Serotonin reuptake inhibitors
- C. Over-the-counter cough and cold medications
- D. All of the above
Correct Answer: D
Rationale: St John's wort interacts with MAOIs, SSRIs (risk of serotonin syndrome), and OTC drugs via CYP450 induction.
A patient with Cushing's syndrome is being treated by X-irradiation of the pituitary. It may take several months of treatment for adequate symptomatic and metabolic improvement. Until that time, which of the following might be administered adjunctively to suppress glucocorticoid synthesis?
- A. Cimetidine
- B. Cortisol (massive doses)
- C. Fludrocortisone
- D. Ketoconazole
Correct Answer: D
Rationale: Ketoconazole inhibits adrenal steroidogenesis, reducing glucocorticoid levels in Cushing's syndrome.