Nokea
When given subcutaneously, how long until neutral protamine Hagedorn insulin begins to take effect (onset of action) after administration?
- A. 15 to 30 minutes
- B. 60 to 90 minutes
- C. 3 to 4 hours
- D. 6 to 8 hours
Correct Answer: B
Rationale: NPH insulin has an onset of 60-90 minutes; shorter is rapid-acting, longer is basal.
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A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes isotretinoin. The nurse reviews the client's medication record and would contact the (HCP) if the client is taking which medication?
- A. Vitamin A
- B. Digoxin (Lanoxin)
- C. Furosemide (Lasix)
- D. Phenytoin (Dilantin)
Correct Answer: A
Rationale: Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A supplements should be discontinued before isotretinoin therapy. Options 2, 3, and 4 are not contraindicated with the use of isotretinoin.
You are assigned to infuse 300 mL of a solution over 2 hours with a drop factor of 15 gtt/mL. What is the flow rate in drops per minute?
- A. 25 gtt/min
- B. 37.5 gtt/min
- C. 45 gtt/min
- D. 75 gtt/min
Correct Answer: B
Rationale: Flow rate = (300 mL 15 gtt/mL) ÷ (2 60) = 4,500 ÷ 120 = 37.5 gtt/min, exactly matching option B.
Richard is 70 years old and has a history of cardiac dysrhythmias. He has been prescribed nadolol. You do his annual laboratory work and find a CrCl of 25 ml/min. What action should you take related to his nadolol?
- A. Extend the dosage interval.
- B. Decrease the dose by 75%.
- C. Take no action because this value is expected in the older adult.
- D. Schedule a serum creatinine level to validate the CrCl value.
Correct Answer: A
Rationale: Reduced renal clearance (CrCl 25 ml/min) requires extending the dosage interval for nadolol.
A nurse is instructing a pregnant patient concerning the potential risk to her fetus from a Pregnancy Category B drug. What would the nurse inform the patient?
- A. Adequate studies in pregnant women have demonstrated there is no risk to the fetus.
- B. Animal studies have not demonstrated a risk to the fetus, but there have been no adequate studies in pregnant women.
- C. Animal studies have shown an adverse effect on the fetus, but there are no adequate studies in pregnant women.
- D. There is evidence of human fetal risk, but the potential benefits from use of the drug may be acceptable despite potential risks.
Correct Answer: B
Rationale: Category B indicates that animal studies have not demonstrated a risk to the fetus. However, there have not been adequate studies in pregnant women to demonstrate risk to a fetus during the first trimester of pregnancy and no evidence of risk in later trimesters. Category A indicates that adequate studies in pregnant women have not demonstrated a risk to the fetus in the first trimester or in later trimesters. Category C indicates that animal studies have shown an adverse effect on the fetus, but no adequate studies in humans. Category D reveals evidence of human fetal risk, but the potential benefits from the use of the drugs in pregnant women may outweigh potential risks.
When providing drug therapy to a patient what is a responsibility of the nurse?
- A. Teaching the patient how to cope with the effects of the drug to ensure the best outcome
- B. Helping the patient analyze the physiological and pathological effects of drugs
- C. Warning the patient how most patients respond to the drug therapy
- D. Encouraging the patient to increase or decrease dosages
Correct Answer: A
Rationale: Teaching patients how to manage drug effects promotes adherence and optimal outcomes, aligning with the nurse's educational role in drug therapy.