Nokea
When assessing a patient prior to starting a drug regimen it is often necessary to have a baseline kidney function study done. What might kidney impairment indicate in relation to drug therapy?
- A. Pharmacodynamics stable at the therapeutic dose
- B. Contraindication to the use of a drug
- C. Increased dosage of a drug
- D. Decreased adverse effects of a drug
Correct Answer: B
Rationale: Kidney impairment may contraindicate certain drugs due to reduced clearance, risking toxicity.
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A nurse is caring for a client who is taking Propylthiouracil. For which of the following adverse effects of this medication should the nurse should be correct
- A. Bradycardia
- B. Insomnia
- C. Heat intolerance
- D. Weight loss
Correct Answer: A
Rationale: Propylthiouracil can cause bradycardia as a rare side effect, requiring monitoring.
Which of the following statements about NSAIDs is true?
- A. Most NSAIDs are weak acids
- B. Most NSAIDs are metabolised by the liver into inactive metabolites
- C. Oxicams tend to have the longest half-lives of all NSAIDs
- D. All of the above
Correct Answer: D
Rationale: All are true: NSAIDs are weak acids, metabolized by the liver, and oxicams (e.g., piroxicam) have long half-lives.
The nurse is checking the medical record of an assigned patient for medication orders. The nurse is unable to read the primary health care provider's handwriting. Which action would be most appropriate?
- A. The nurse should question the order with the primary health care provider.
- B. The nurse should try to interpret the handwriting.
- C. The nurse should confirm the order with a nearby health care provider.
- D. The nurse should obtain a verbal order.
Correct Answer: A
Rationale: Any order that is unclear, particularly due to illegible handwriting, should be questioned. The nurse should not try to interpret the handwriting as it may lead to a misinterpretation. The nurse should also not confirm the order with any other physician who is nearby. Administering drugs based on verbal orders is permissible only during emergencies.
Zainab is taking lamotrigine (Lamictal) and presents to the clinic with fever and lymphadenopathy. Initial evaluation and treatment includes:
- A. Reassuring her she has a viral infection and to call if she isn't better in 4 or 5 days
- B. Ruling out a hypersensitivity reaction that may lead to multi-organ failure
- C. Rapid strep test and symptomatic care if strep test is negative
- D. Observation only, with further assessment if she worsens
Correct Answer: B
Rationale: Fever and lymphadenopathy suggest a serious lamotrigine hypersensitivity reaction.
Monitoring for a patient being prescribed iron for iron deficiency anemia includes:
- A. Reticulocyte count 1 week after therapy is started
- B. Complete blood count every 2 weeks throughout therapy
- C. Hemoglobin level at 1 week of therapy
- D. INR weekly throughout therapy
Correct Answer: A
Rationale: Reticulocyte count at 1 week assesses iron therapy response; CBC or hemoglobin checks are later, and INR is irrelevant.