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To reduce medication errors, the Institute of Safe Medication Practices recommends:
- A. Using only brand names on prescriptions
- B. Avoiding the use of 'tall man' lettering
- C. Avoiding the use of error-prone abbreviations
- D. Using decimals instead of fractions when prescribing
Correct Answer: C
Rationale: Choice C is correct because the ISMP recommends avoiding error-prone abbreviations (e.g., ‘U' for units) to prevent misinterpretation and errors, a proven safety strategy. Choice A is incorrect as brand names alone don't reduce errors—generics are standard. Choice B is wrong because ‘tall man' lettering (e.g., LisinOPRIL) helps, not harms. Choice D is incorrect since decimals can confuse (e.g., .5 vs. 0.5)—whole numbers are safer.
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Strategies to monitor controlled substance use include:
- A. Prescription drug monitoring programs
- B. Patient education
- C. Urine drug screening
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because PDMPs track prescriptions, education informs risks, and urine screening detects misuse—all key monitoring tools per guidelines. Choice A is incorrect alone as it's one method. Choice B is wrong by itself because education is just part. Choice C is incorrect solo since screening is only one approach.
The primary care NP performs a physical examination on an 89-year-old patient who is about to enter a skilled nursing facility. The patient reports having had chickenpox as a child. The NP should:
- A. obtain a varicella titer.
- B. administer the Varivax vaccine.
- C. give the patient the Zostavax vaccine.
- D. plan to prescribe Zovirax if the patient is exposed to shingles.
Correct Answer: C
Rationale: The correct answer is C because Zostavax is recommended for adults over 60 to prevent shingles, regardless of prior chickenpox. Choice A is incorrect (titer not needed). Choice B is wrong (Varivax not for shingles). Choice D is inaccurate (prophylaxis not standard).
Differences between brand-name drugs and their generic equivalents include:
- A. Active ingredient
- B. Cost
- C. Color of the tablet
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because generics have the same active ingredient as brand-name drugs but typically cost less, per FDA bioequivalence rules. Choice A is incorrect as active ingredients are identical. Choice C is wrong because color may differ but isn't a functional difference. Choice D is incorrect since only cost is a consistent distinction.
Food or drink that should be avoided when taking a prescription for simvastatin includes:
- A. Milk
- B. Orange juice
- C. Grapefruit juice
- D. Green leafy vegetables
Correct Answer: C
Rationale: Choice C is correct because grapefruit juice inhibits CYP3A4, which metabolizes simvastatin, increasing drug levels and rhabdomyolysis risk, so it's to be avoided. Choice A is incorrect as milk doesn't affect simvastatin significantly. Choice B is wrong because orange juice has no notable interaction. Choice D is incorrect since green leafy vegetables don't impact simvastatin metabolism.
A client with atrial fibrillation is prescribed warfarin (Coumadin). Which instruction should the nurse give to the client regarding lifestyle changes?
- A. Avoid prolonged sitting or standing.
- B. Use an electric razor to prevent cuts.
- C. Take your medication with a full glass of water.
- D. Eat a diet low in protein.
Correct Answer: B
Rationale: The correct answer is B. Using an electric razor is advised to prevent cuts, which is crucial for individuals taking warfarin due to the increased risk of bleeding associated with this medication. Lifestyle changes related to warfarin therapy focus on minimizing the risk of bleeding, and using safety measures such as an electric razor is a practical recommendation to reduce the likelihood of injury. Choices A, C, and D are incorrect. Avoiding prolonged sitting or standing is more related to preventing blood clots than to the bleeding risk of warfarin. Taking warfarin with a full glass of water is not a specific lifestyle change associated with its use. Eating a diet low in protein is not a typical recommendation for individuals on warfarin therapy.