Nokea
True contraindications to diphtheria, tetanus, and acellular pertussis (DTaP or Tdap) vaccine include:
- A. Fever up to 104°F (40.5°C) after previous DTaP vaccine
- B. Family history of seizures after DTaP vaccine
- C. Adolescent pregnancy
- D. Anaphylactic reaction with a previous dose
Correct Answer: D
Rationale: Anaphylaxis is a true contraindication to DTaP/Tdap; fever , family history , or pregnancy are not.
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Which one of the following statements is NOT true of warfarin?
- A. It is extensively 99% bound to plasma albumin
- B. Its use in pregnant women is contraindicated because it is teratogenic
- C. It is active in vitro
- D. Its induced bleeding can be conteracted by treatment with phytonadione
Correct Answer: C
Rationale: Warfarin acts in vivo by inhibiting vitamin K epoxide reductase, not in vitro; thus, is false.
All of the following adverse effects commonly occur in glucocorticoid therapy except:
- A. Osteoporosis
- B. Increased risk of infection
- C. Hypotension
- D. Emotional disturbances
Correct Answer: C
Rationale: Glucocorticoids cause hypertension, not hypotension, due to mineralocorticoid effects and fluid retention.
A patient presents to the emergency department with a drug level of 50 units/mL. The half-life of this drug is 1 hour. With this drug, concentrations above 25 units/mL are considered toxic and no more drug is given. How long will it take for the blood level to reach the non-toxic range?
- A. 30 minutes
- B. 1 hour
- C. 2 hours
- D. 3 hours
Correct Answer: B
Rationale: Half-life is the time required for the serum concentration of a drug to decrease by 50%. After 1 hour, the serum concentration would be 25 units/mL (50/2) if the body can properly metabolize and excrete the drug. After 2 hours, the serum concentration would be 12.5 units/mL (25/2) and reach the nontoxic range. In 30 minutes the drug level would be 37.5 units/mL, whereas in 3 hours the drug level would be 6.25.
The nurse promotes optimal drug effectiveness by doing what? (Select one that does not apply.)
- A. Incorporate basic history and physical assessment factors into the plan of care.
- B. Evaluate the effectiveness of drugs after they have been administered.
- C. Modify the drug regimen to modify adverse or intolerable effects.
- D. Minimize the number of medications administered to patients.
Correct Answer: D
Rationale: Incorporate basic history and physical assessment factors into any plan of care so that obvious problems can be identified and handled promptly. If a drug simply does not do what it is expected to do, further examine the factors that are known to influence drug effects. Frequently, the drug regimen can be modified to deal with that influence. Minimizing the number of medications administered is usually not an option because each drug is ordered for a reason of necessity for the patient.
Which of the following statement is correct for Amantadine?
- A. Has agonistic action on NDMA type of glutamate receptors
- B. It was developed as antiepileptic drug
- C. Acts as a D2 blocker
- D. Produces livedo reticularis as side effect
Correct Answer: D
Rationale: Amantadine, an antiviral and antiparkinsonian drug, can cause livedo reticularis (a skin mottling side effect); it blocks NMDA receptors, not agonizes them, and enhances dopamine release, not blocks D2.