Nokea
What does the provider understand about the issue of 'Diabetic Renal Protection' with angiotensin-converting enzyme (ACE) medications? Diabetes mellitus patients:
- A. Have a reduced rate of renal progression, but still need to be discontinued when advanced renal issues present
- B. Who start these medications never progress to renal nephropathy
- C. With early renal dysfunction will see it reverse when on ACE medications
- D. Without renal issues are the only ones who benefit from ACE protection
Correct Answer: A
Rationale: ACE inhibitors slow renal progression in diabetes but are stopped in advanced renal failure.
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A nurse is administering a Dopamine infusion at a low dose to a client who has severe heart failure. Which of the following findings is an expected effect of this medication?
- A. Lowered heart rate
- B. Increased myocardial contractility
- C. Decreased conduction through the AV node
- D. Vasoconstriction of renal blood vessel
Correct Answer: B
Rationale: Low-dose dopamine increases contractility via beta-adrenergic effects, improving cardiac output.
In which of the following patients would a nurse expect to see an alteration in drug metabolism?
- A. A 35-year-old female with cervical cancer
- B. A 41-year-old male with kidney stones
- C. A 50-year-old male with cirrhosis of the liver
- D. A 62-year-old female in acute renal failure
Correct Answer: C
Rationale: The liver is the most important site of drug metabolism. If the liver is not functioning effectively, as in patients with cirrhosis, drugs will not be metabolized normally and toxic levels could develop. In cirrhosis patients the drug dosage will need to be altered to ensure normal levels in the body.
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.
The nurse applies the nursing process in medication therapy to ensure what?
- A. That medications are given at the right time
- B. That care is efficient and effective
- C. That the right dose of the drug is given to the patient
- D. That the right drug is given to the right patient at the right time
Correct Answer: B
Rationale: The nursing process ensures efficient, effective care, encompassing all aspects of safe administration.
In post menopausal women who are receiving estrogen replacement therapy, medroxyprogesterone is administered concurrently to reduce the risk of:
- A. Atherosclerosis
- B. Endometrial cancer
- C. Hypertension
- D. Osteoporosis
Correct Answer: B
Rationale: Progestins like medroxyprogesterone reduce estrogen-induced endometrial hyperplasia and cancer risk.