Tianeptin is
- A. 5-HT antagonist
- B. Nor adrenaline uptake inhibitor
- C. 5-HT reuptake enhancer
- D. Dopamine antagonist
Correct Answer: C
Rationale: Tianeptin enhances serotonin reuptake, unlike typical SSRIs.
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A nurse is reviewing a new prescription for Ondansetron 4 mg PO PRN for nausea and vomiting for a client who has Hyperemesis Gravidarum. The nurse should clarify which of the following parts of the prescription with the provider?
- A. Name
- B. Dosage
- C. Route
- D. Frequency
Correct Answer: D
Rationale: PRN (as needed) lacks a specific frequency (e.g., every 4 hours), requiring clarification for safe administration.
A nurse is required to give an intramuscular (IM) injection to an 18-month-old toddler. The nurse would prepare which site for administration?
- A. Dorsogluteal site
- B. Deltoid muscle
- C. Vastus lateralis
- D. Ventrogluteal site
Correct Answer: C
Rationale: The vastus lateralis site is frequently used for infants and small children because it is more developed than the other intramuscular sites such as the dorsogluteal and deltoid muscle. Ventrogluteal sites may be used in children who have been ambulating for more than 2 years.
Which route of drug administration is most likely to lead to first pass effect?
- A. Sublingual
- B. Oral
- C. Intravenous
- D. Intramuscular
Correct Answer: B
Rationale: Oral administration subjects drugs to the first-pass effect, where they are metabolized by the liver via the portal vein before reaching systemic circulation, reducing bioavailability.
Cruciferous vegetables may alter drug pharmacokinetics by:
- A. Enhancing absorption of weakly acidic drugs
- B. Altering CYP 3A4 activity, leading to elevated levels of drugs, such as the statins
- C. Inducing CYP 1A2, possibly leading to therapeutic failure of drugs metabolized by CYP 1A2
- D. Decreasing first-pass metabolism of drugs
Correct Answer: C
Rationale: Cruciferous vegetables (e.g., broccoli) induce CYP1A2, accelerating metabolism of drugs like theophylline, potentially reducing efficacy.
The nurse is reviewing the history and physical examination of a client who will be receiving asparaginase (Elspar), an antineoplastic agent. The nurse consults with the registered nurse regarding the administration of the medication if which of the following is documented in the client's history?
- A. Pancreatitis
- B. Diabetes mellitus
- C. Myocardial infarction
- D. Chronic obstructive pulmonary disease
Correct Answer: A
Rationale: Asparaginase (Elspar) is contraindicated if hypersensitivity exists, in pancreatitis, or if the client has a history of pancreatitis. The medication impairs pancreatic function and pancreatic function tests should be performed before therapy begins and when a week or more has elapsed between administration of the doses. The client needs to be monitored for signs of pancreatitis, which include nausea, vomiting, and abdominal pain. The conditions noted in options 2, 3, and 4 are not contraindicated with this medication.
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