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Under new U.S. Food and Drug Administration labeling, Pregnancy Categories will be:
- A. Strengthened with a new coding such as C+ or C- to discern when a drug is more or less toxic to the fetus
- B. Changed to incorporate a pregnancy risk summary and clinical considerations on the drug label
- C. Eliminated, and replaced with a link to the National Library of Medicine TOXNET Web site for in-depth information regarding pregnancy concerns
- D. Clarified to include information such as safe dosages in each trimester of pregnancy
Correct Answer: B
Rationale: FDA replaced categories with risk summaries and clinical considerations for clearer, narrative-based guidance, effective 2015.
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The nurse receives an order to administer an unfamiliar medication and obtains a nurses drug guide published four years earlier. What is the nurses most prudent action?
- A. Find a more recent reference source.
- B. Use the guide if the drug is listed.
- C. Ask another nurse for drug information.
- D. Verify the information in the guide with the pharmacist.
Correct Answer: A
Rationale: The nurse is responsible for all medications administered and must find a recent reference source to ensure the information learned about the medication is correct and current. Using an older drug guide could be dangerous because it would not contain the most up-to-date information. Asking another nurse or the pharmacist does not guarantee accurate information will be obtained and could harm the patient if the information is wrong.
A nurse is calculating a child's medication dose by using Clark's Rule. Which of the following calculations represents the application of Clark's Rule?
- A. Infant's age in months/150 months the average adult dose
- B. Child's age in years/child's age in years +12 times the average adult dose
- C. Weight of child in pounds/150 pounds the average adult dose
- D. Surface area in square meters/1.73 the average adult dose
Correct Answer: C
Rationale: Clark's Rule uses the child's weight to calculate the dose and assumes the adult dose is based on a 150-pound person. Fried's Rule applies to a child younger than 1 year of age and assumes that an adult dose would be appropriate for a child who is 12.5 years (150 months) old. Young's Rule applies to children 1 to 12 years of age. Surface area calculation of a child's dose is determined with the use of a nomogram including the child's height and weight.
A 25-year-old woman comes to the clinic complaining of rapid heart rate and easy fatigability. Laboratory results reveal low hemoglobin levels and microcytic red blood cells. The most suitable therapy for her condition will be:
- A. Folic acid
- B. Epoiten alfa
- C. Ferrous sulfate
- D. Vitamin B12
Correct Answer: C
Rationale: Microcytic anemia suggests iron deficiency; ferrous sulfate is the standard treatment.
A nurse is collecting data from a client who is taking Gemfibrozil. Which of the following assessment findings should the nurse identify as an adverse reaction to the medication?
- A. Mental status changes
- B. Tremor
- C. Jaundice
- D. Pneumonia
Correct Answer: C
Rationale: Gemfibrozil can cause hepatotoxicity, leading to jaundice .
A 35-year-old woman has Graves' disease, a small goiter, and symptoms that are deemed 'mild-to-moderate.' Propylthiouracil is prescribed. Which of the following is the most serious adverse response to this drug, for which close monitoring is required?
- A. Agranulocytosis
- B. Cholestatic jaundice
- C. Gout
- D. Renal tubular necrosis
Correct Answer: A
Rationale: Agranulocytosis is a severe, potentially fatal side effect of propylthiouracil requiring close monitoring due to its impact on white blood cell production.