Nokea
When a primary health care provider phones in a medication order for a client, the nurse should do which of the following? (Select one that does not apply.)
- A. Write down the order.
- B. Record the order as soon as the MAR is retrieved.
- C. Repeat back the information exactly as written.
- D. Clarify any unclear information.
Correct Answer: B
Rationale: If a verbal order is given over the telephone, the nurse writes down the order immediately, repeats back the information exactly as written, and then asks for a verbal confirmation that it is correct. Any order that is unclear should be questioned and clarified.
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A 60-year-old man with Type 2 diabetes mellitus is treated with pioglitazone. Which of the following phrases summarizes best this drug's main mechanism of action?
- A. Blocks intestinal carbohydrate absorption
- B. Causes glycosuria (increased renal glucose excretion)
- C. Increases hepatic gluconeogenesis
- D. Increases target tissue sensitivity to insulin
Correct Answer: D
Rationale: Pioglitazone enhances insulin sensitivity in target tissues like muscle and fat via PPAR-gamma activation.
A nurse is teaching the parents of a child who has a new prescription for Desipramine. The nurse should instruct the parents that which of the following adverse effects is the priority to report to the provider?
- A. Constipation
- B. Suicidal thoughts
- C. Photophobia
- D. Dry mouth
Correct Answer: B
Rationale: Suicidal thoughts are a critical adverse effect of tricyclics like desipramine, requiring immediate reporting.
Which of the following drugs is considered a first-generation cephalosporin?
- A. Cefepime
- B. Cefazolin
- C. Ceftriaxone
- D. Cephalexin
Correct Answer: B
Rationale: Cefazolin is a first-generation cephalosporin, effective against Gram-positive bacteria, unlike cefepime (fourth) or ceftriaxone (third).
You are going to prescribe a drug and the electronic health record (EHR) alerts you that there is a potential drug-drug interaction. The alert is generated by:
- A. The Food and Drug Administration MedWatch system
- B. TOXNET, the National Institutes of Health alert system
- C. The EHR clinical decision support system
- D. Lexicomp, a commercial medication alert system
Correct Answer: C
Rationale: EHR clinical decision support systems generate real-time drug interaction alerts.
When prescribing NSAIDS, a complete drug history should be conducted as NSAIDs interact with these drugs:
- A. Omeprazole, a proton pump inhibitor
- B. Combined oral contraceptives
- C. Diphenhydramine, an antihistamine
- D. Warfarin, an anticoagulant
Correct Answer: D
Rationale: NSAIDs increase bleeding risk with warfarin; interactions with PPIs or contraceptives are less significant.