Nokea
The volume of distribution (Vd) for a drug highly bound in peripheral tissues would be?
- A. High
- B. Low
- C. Unchanged
- D. Cannot be determined
Correct Answer: A
Rationale: A drug highly bound in peripheral tissues has a high Vd, as it distributes extensively beyond plasma, often exceeding total body water (e.g., >0.6 L/kg).
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The nurse is preparing to administer an intradermal injection. The nurse would insert the needle at which angle?
- A. 15 degrees
- B. 30 degrees
- C. 45 degrees
- D. 90 degrees
Correct Answer: A
Rationale: When giving an intradermal injection, the needle is inserted bevel up at a 15-degree angle. The nurse would insert the needle at a 90-degree angle for an intramuscular injection or for a patient who is obese and requires a subcutaneous injection. Typically a subcutaneous injection is given at a 45-degree angle.
Research has shown that when patients who are covered by Medicare Part D reach the 'donut hole' in coverage they:
- A. Ask for extra refills of medication to get them through the months of no coverage
- B. Fill their prescriptions less frequently, including critical medications such as warfarin or a statin
- C. Fill their critical medications, but hold off on filling less-critical medications
- D. Demonstrate no change in their prescription filling pattern
Correct Answer: B
Rationale: Patients reduce prescription filling, even for critical drugs, during the donut hole.
The nursing instructor is discussing drug therapy in the older adult. What would the instructor tell the students could affect therapeutic dosing in an older adult?
- A. In older adults, drugs have decreased GI absorption.
- B. In older adults
- C. In older adults, drugs are distributed to a smaller portion of the tissue.
- D. In older adults, drugs have an increased action.
Correct Answer: A
Rationale: Decreased GI absorption in older adults can reduce drug bioavailability, necessitating dosage adjustments.
Not metabolized in liver
- A. Cimetidine
- B. Phenytoin
- C. Diazepam
- D. Penicillin G
Correct Answer: D
Rationale: Penicillin G is primarily excreted unchanged by the kidneys, unlike the others metabolized by the liver.
The nurse learns that a drug needed by the patient is classified as an orphan drug and recognizes what as a reason for this classification? (Select one that does not apply.)
- A. The drug is rarely prescribed.
- B. The drug has dangerous adverse effects.
- C. The drug treats a rare disease.
- D. The patent on the medication is still effective.
Correct Answer: D
Rationale: Drugs are classified as orphan drugs when they are not financially viable for a drug company to produce either because of risk for lawsuits about adverse effects or because the drug is not prescribed, which is often seen in rare diagnoses. Generic drugs are not produced until the patent expires, but this has no impact on classifying a particular drug as an orphan drug. Generic drugs are often produced by companies that only manufacture drugs without conducting research, but this has no bearing on the classification of orphan drugs.