Nokea
When patients are started on darbepoetin alfa (Aranesp) they need monitoring of their blood counts to determine a dosage adjustment in:
- A. 6 weeks if they are a cancer patient
- B. 1 week if they have chronic renal failure
- C. 2 weeks if they are taking it for allogenic transfusion
- D. Each week throughout therapy
Correct Answer: A
Rationale: Cancer patients need blood count checks at 6 weeks for darbepoetin adjustment; renal patients adjust sooner, typically 2-4 weeks.
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Which of the following is not hypoglicemic mechanism of action of metformin?
- A. Enhance insulin release by pancreatic beta cells
- B. Increase cell permeability of glucose and utilisation
- C. Decrease gluconeogenesis
- D. Interfere carbohydrate absorption in the gut
Correct Answer: A
Rationale: Metformin does not enhance insulin release; it improves insulin sensitivity and reduces hepatic glucose production.
A nurse is reviewing laboratory findings and notes that a client's plasma Lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse?
- A. Perform immediate gastric lavage.
- B. Prepare the client for hemodialysis.
- C. Administrative and additional oral dose of lithium.
- D. Request a stat repeat of the laboratory test
Correct Answer: B
Rationale: A level of 2.1 mEq/L indicates toxicity (normal 0.6-1.2 mEq/L); hemodialysis is used for severe cases.
Which of the following is a disadvantage of IM administration?
- A. Larger volumes can be used
- B. Can affect lab tests
- C. Painful
- D. B and C
Correct Answer: C
Rationale: Intramuscular (IM) administration is painful due to needle insertion, though larger volumes are an advantage; affecting lab tests is less specific, making C the primary disadvantage.
An older adult experiencing shortness of breath is brought to the hospital by her daughter. While obtaining the medication history from the patient and her daughter, the nurse discovers that neither has a list of the patient's current medications or prescriptions. The patient has a weekly pill dispenser that contains four different pills. The prescriptions are filled through the local pharmacy. Which resource would be appropriate to use in determining the medication names and doses?
- A. Martindale-The Complete Drug Reference
- B. Drugs and Facts Comparisons
- C. Senior citizens' center
- D. Patient's home pharmacy
Correct Answer: D
Rationale: The patient's pharmacy maintains an accurate record of all current medications, making it the best resource for identifying the drugs and doses.
A 52-year-old overweight woman presents to the clinic for a diabetes management. She had not been doing well controlling her blood sugars with metformin. Her last hemoglobin A1c was 13.4%, despite her taking her medication every day. The physician decides to start her on a long-acting insulin that is injected only once a day for better glucose control. Also, he wants the insulin to have a minimal risk of hypoglycemia. What is the most likely medication given to this patient?
- A. Insulin aspart
- B. Insulin glargine
- C. Insulin lispro
- D. NPH insulin
Correct Answer: B
Rationale: Insulin glargine is a long-acting, peakless insulin administered once daily, with a lower risk of hypoglycemia compared to other insulins.