Nokea
When discussing dosage calculation for pediatric patients with a clinical pharmacist, the nurse notes that which type of dosage calculation is used most commonly in pediatric calculations?
- A. West nomogram
- B. Clark rule
- C. Height-to-weight ratio
- D. Milligram per kilogram of body weight formula
Correct Answer: D
Rationale: The milligram per kilogram formula, based on body weight, is the most common method of calculating doses for pediatric patients. West nomogram and Clark rule are available but less commonly used, and height-to-weight ratio is not a standard method.
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An elderly patient with a new diagnosis of hypertension will be receiving a new prescription for an antihypertensive drug. The nurse expects which type of dosing to occur with this drug therapy?
- A. Drug therapy will be based on the patient's weight.
- B. Drug therapy will be based on the patient's age.
- C. The patient will receive the maximum dose that is expected to reduce the blood pressure.
- D. The patient will receive the lowest possible dose at first, and then the dose will be increased as needed.
Correct Answer: D
Rationale: As a general rule, dosing for elderly patients should follow the principle of 'start low, and go slow,' meaning start with the lowest possible dose and increase slowly if needed, based on patient response. Dosing is not primarily based on weight or age, and maximum doses are not initially given.
For accurate medication administration to pediatric patients, the nurse must consider which of these factors?
- A. Organ maturity
- B. Renal output
- C. Body temperature
- D. Height
Correct Answer: A
Rationale: To administer medications to pediatric patients accurately, one must take into account organ maturity, body surface area, age, and weight. Renal output, body temperature, and height alone are not primary considerations for accurate medication administration.
The nurse is assessing a newly admitted 83-year-old patient and determines that the patient is experiencing polypharmacy. Which statement most accurately illustrates polypharmacy?
- A. The patient is experiencing multiple illnesses.
- B. The patient uses one medication for an illness several times per day.
- C. The patient uses over-the-counter drugs for an illness.
- D. The patient uses multiple medications simultaneously.
Correct Answer: D
Rationale: Polypharmacy usually occurs when a patient has several illnesses and takes medications for each of them, possibly prescribed by different specialists who may be unaware of other treatments the patient is undergoing. It involves multiple medications, not just multiple illnesses, a single medication, or only over-the-counter drugs.
The nurse is aware that confusion, forgetfulness, and increased risk for falls are common responses in an elderly patient who is taking which type of drug?
- A. Laxatives
- B. Anticoagulants
- C. Sedatives
- D. Antidepressants
Correct Answer: C
Rationale: Sedatives and hypnotics often cause confusion, daytime sedation, ataxia, lethargy, forgetfulness, and increased risk for falls in the elderly. Laxatives, anticoagulants, and antidepressants may cause other adverse effects, but not the specific ones mentioned.
Drug transfer to the fetus is more likely during the last trimester of pregnancy for which reason?
- A. Decreased fetal surface area
- B. Increased placental surface area
- C. Enhanced blood flow to the fetus
- D. Increased amount of protein-bound drug in maternal circulation
Correct Answer: C
Rationale: Drug transfer to the fetus is more likely during the last trimester of pregnancy as a result of enhanced blood flow to the fetus. Increased fetal surface area, not decreased, is a factor that affects drug transfer to the fetus. The placenta's surface area does not increase during this time. Drug transfer is increased because of an increased amount of free drug, not protein-bound drug, in the mother's circulation.