Nokea
The use of information technology for quality improvement in pharmacotherapeutics includes:
- A. Incorporating the use of 'apps' into all patient encounters
- B. Tracking data trends within the practice via the electronic health record database
- C. Informing patients that they have access to their medication list via the Internet
- D. Using macros for individualizing patient care management
Correct Answer: B
Rationale: Tracking data trends in EHRs supports quality improvement in pharmacotherapeutics.
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A nurse is preparing to administer a prescribed medication to a client. The nurse integrates knowledge of which of the following as a possible factor that could influence the drug response?
- A. Age
- B. Polypharmacy
- C. Weight
- D. All the above
Correct Answer: D
Rationale: Drug response can be influenced by the following factors: age, polypharmacy, weight, sex, disease, and genetics.
Sarah, a 42-year-old female, requests a prescription for an anorexiant to treat her obesity. A trial of phentermine is prescribed. Prescribing precautions include:
- A. Understanding that obesity is a contraindication to prescribing phentermine
- B. Anorexiants may cause tolerance and should only be prescribed for 6 months
- C. Patients should be monitored for postural hypotension
- D. Renal function should be monitored closely while on anorexiants
Correct Answer: C
Rationale: Phentermine can cause postural hypotension, requiring monitoring.
The clinic nurse is performing an admission assessment on a client. The nurse notes that the client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the client is being treated for:
- A. Acne
- B. Eczema
- C. Hair loss
- D. Herpes simplex
Correct Answer: A
Rationale: Azelaic acid is a topical medication used to treat mild to moderate acne. The acid appears to work by suppressing the growth of Propionibacterium acnes and decreasing the proliferation of keratinocytes. Options 2, 3, and 4 are incorrect.
The patient, diagnosed with cancer, is receiving morphine sulfate (a potent narcotic pain reliever) to relieve cancer pain. Approximately every 7 days the medication is no longer effective in controlling the patient's pain and a larger dose is needed to have the same effect. How might the nurse explain why this is happening?
- A. Tolerance
- B. Cumulation
- C. Interactions
- D. Addiction
Correct Answer: A
Rationale: The body may develop a tolerance to some drugs over time. Tolerance may arise because of increased biotransformation of the drug, increased resistance to its effects, or other pharmacokinetic factors. When tolerance occurs, the amount of the drug no longer causes the same reaction. Therefore, increasingly larger doses are needed to achieve a therapeutic effect. Cumulative effect occurs when the drug is not properly eliminated and more of the drug is administered, resulting in toxic levels accumulating. Interactions occur when the drug reacts badly with another substance such as food, another drug, or an alternative or complementary therapy. Addiction is the psychological need for a substance.
One major drug used to treat bipolar disease is lithium. Because lithium has a narrow therapeutic range, it is important to recognize symptoms of toxicity, such as:
- A. Orthostatic hypotension
- B. Agitation and irritability
- C. Drowsiness and nausea
- D. Painful urination and abdominal distention
Correct Answer: C
Rationale: Lithium toxicity commonly presents with drowsiness and nausea.