Nokea
When educating patients who are starting on inhaled corticosteroids, the provider should tell them that:
- A. They need to get any live vaccines before starting the medication
- B. Inhaled corticosteroids need to be used daily during asthma exacerbations to be effective
- C. Patients should rinse their mouths out after using the inhaled corticosteroid to prevent thrush
- D. They can triple the dose number of inhalations of medication during colds to prevent needing systemic steroids
Correct Answer: C
Rationale: Rinsing the mouth prevents oral thrush, a common side effect of inhaled corticosteroids; vaccines , exacerbation-only use , or dose tripling are incorrect.
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The nurse is preparing to administer a prescribed drug to a patient. The patient looks at the tablet and says, 'This doesn't look like my usual pill.' Which response by the nurse would be most appropriate?
- A. This is the same pill your doctor has been ordering.'
- B. It must be from a different manufacturer.'
- C. It looks different? Are you sure?'
- D. Let me double check with your doctor and the order.'
Correct Answer: D
Rationale: If the patient makes any statement about the drug, the nurse needs to hold the drug and investigate the patient's statement, double checking the chart and the order and obtaining clarification and/or confirmation from the prescriber. It may be that the dosage or manufacturer has changed and that is what makes the pill look different. It is always important to err on the side of caution. Telling the patient that the pill is the same or that it is from a different manufacturer may be true, but the nurse needs to confirm that before giving it to the patient. Repeating the patient's statement and then asking him if he is sure is inappropriate because it implies that the patient is incorrect.
Which statement best describes drug efficacy/toxicity in pediatric clients?
- A. Drug requirements for infants have been extensively studied.
- B. Drug dosage is altered by age and weight in children.
- C. Children always need smaller doses of medication than adults.
- D. Infants and children are always at greater risk for drug toxicity with any medication.
Correct Answer: B
Rationale: Pediatric dosing adjusts for age and weight to ensure efficacy and minimize toxicity, reflecting developmental differences.
Glucocorticoids:
- A. Decrease amount of immunocompetent cells and macrophages in the blood
- B. Stimulate activity of macrophages and monocytes
- C. Increase amount of T lymphocytes
- D. Stimulate production of antibodies
Correct Answer: A
Rationale: Glucocorticoids reduce immunocompetent cells and macrophages, contributing to their immunosuppressive effects.
A nurse is teaching a client who has a new prescription for digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching?
- A. Contact provider if heart rate is less than 60/min.
- B. Check pulse rate for 30 seconds and multiply result by 2.
- C. Increase intake of sodium.
- D. Take with food if nausea occur
Correct Answer: A
Rationale: Bradycardia (<60/min, A) is a sign of digoxin toxicity to report; pulse should be checked for 1 minute.
Patients who are on chronic long-term proton pump inhibitor therapy require monitoring for:
- A. Iron deficiency anemia, vitamin B12 and calcium deficiency
- B. Folate and magnesium deficiency
- C. Elevated uric acid levels leading to gout
- D. Hypokalemia and hypocalcemia
Correct Answer: A
Rationale: PPIs impair absorption of iron, B12, and calcium long-term; magnesium is also a risk but less emphasized here.