Nokea
What is the main adverse effect of digoxin?
- A. Bradycardia
- B. Tachycardia
- C. Hypotension
- D. Arrhythmias
Correct Answer: D
Rationale: D' is correct because digoxin's narrow therapeutic window often leads to arrhythmias (e.g., AV block, ventricular tachycardia) due to calcium overload, per toxicology. 'A' (bradycardia) occurs but is less dominant than arrhythmias. 'B' (tachycardia) is rare. 'C' (hypotension) is secondary. Arrhythmias are the primary concern, requiring ECG monitoring.
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Which drug can cause lung fibrosis as a side effect?
- A. Amiodarone
- B. Sotalol
- C. Lidocaine
- D. Flecainide
Correct Answer: A
Rationale: A' is correct because amiodarone causes pulmonary fibrosis due to chronic lung toxicity, per pulmonology. 'B' (sotalol), 'C' (lidocaine), and 'D' (flecainide) don't affect lungs. Amiodarone's long-term use requires lung monitoring.
The abbreviation used on prescriptions for four times a day is
- A. bid.
- B. qid.
- C. qd.
- D. ud.
Correct Answer: B
Rationale: Qid (B) means four times a day (quarter in die), per the text, making it correct. Bid (A) is twice, qd (C) daily, and ud (D) as directed, confirming B.
Drug of choice for ventricular arrhythmias due to myocardial infarction (MI) is
- A. Quinidine
- B. Amiodarone
- C. Xylocaine (Lidocaine)
- D. Diphenylhydantoin
Correct Answer: C
Rationale: C' is correct because lidocaine (Class IB) is the drug of choice for ventricular arrhythmias post-MI, rapidly suppressing ectopic beats, per ACLS. 'A' (quinidine) risks torsades. 'B' (amiodarone) is broader but slower. 'D' (phenytoin) is less used. Lidocaine's specificity is key.
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: A' is correct because medication reconciliation compares current orders with all medications a patient takes, preventing errors, per Joint Commission standards. 'B' is unrelated—high-alert meds don't define it. 'C' is incident reporting, not reconciliation. 'D' describes the MAR, not the process. 'A' ensures continuity and safety across care transitions.
A patient is considering using herbal supplements and asks the nurse about them. Which response by the nurse would be most appropriate?
- A. Herbal supplements are safe to use because they are regulated closely
- B. Herbal supplements can affect the way other medications will act
- C. Taking more than the recommended amount usually is not harmful because they are natural
- D. The risk of the supplement interacting with any prescription medications is extremely low
Correct Answer: B
Rationale: Herbal supplements can interact with medications (B), per the text. They aren't closely regulated (A), overdosing can harm (C), and interaction risk isn't low (D). The text warns of potential effects, making B the most appropriate advice.