Nokea
What is medication reconciliation?
- A. Comparing the patient's current medication orders to all of the medications actually being taken
- B. The administration of high alert medications that have been ordered on admission to an acute care facility
- C. The completion of an incident report following a variance that resulted in a serious complication
- D. A printout of computerized patient data that identifies the times that all of the ordered medications are to be administered
Correct Answer: A
Rationale: Medication reconciliation is the process of comparing a patient's current medication orders to all of the medications that the patient is actually taking. Administering high alert medications and completing an incident report are not the same as medication reconciliation. A printout of computerized patient data that identifies the times that all of the ordered medications are to be administered is a description of the medication administration record (MAR), not a description of medication reconciliation.
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Elderly patients who are started on levothyroxine for hypothyroidism may experience which of the following as a side effect that would require reevaluation of dosage?
- A. Excessive sedation
- B. Tachycardia and angina
- C. Weight gain
- D. Cold intolerance
Correct Answer: B
Rationale: Levothyroxine can cause tachycardia and angina in the elderly if overdosed; sedation or weight gain suggest underdosing.
The nurse admits a patient to the unit and learns the patient has recently been diagnosed with chronic renal failure but has not informed the primary care provider of this diagnosis. What is the nurse's first priority?
- A. Administer medications ordered immediately.
- B. Maintain the patient's confidentiality.
- C. Call the admitting physician immediately.
- D. Provide teaching about chronic renal failure
Correct Answer: C
Rationale: Renal failure affects drug clearance; informing the physician ensures safe therapy adjustments.
Which of the following is not hypoglicemic mechanism of action of metformin?
- A. Enhance insulin release by pancreatic beta cells
- B. Increase cell permeability of glucose and utilisation
- C. Decrease gluconeogenesis
- D. Interfere carbohydrate absorption in the gut
Correct Answer: A
Rationale: Metformin does not enhance insulin release; it improves insulin sensitivity and reduces hepatic glucose production.
A patient comes to the ER having his quadriceps muscle constantly contracted, you should give him:
- A. Norepinephrine to stimulate the sympathetic nervous system
- B. An antagonist for Norepinephrine
- C. Agonist for acetylcholine
- D. Both B and C
Correct Answer: D
Rationale: Both B and C are correct: a norepinephrine antagonist (e.g., beta-blocker) or acetylcholine agonist (e.g., to relax via parasympathetic action) could relieve muscle contraction.
Larry is taking allopurinol to prevent gout. Monitoring of a patient who is taking allopurinol includes:
- A. Complete blood count
- B. Blood glucose
- C. C-reactive protein
- D. BUN, creatinine, and creatinine clearance
Correct Answer: D
Rationale: Allopurinol requires renal function monitoring (BUN, creatinine) due to toxicity risk; CBC is less routine.