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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After teaching a group of nursing students about pharmacokinetics, the instructor determines that the teaching was successful when the students identify which of the following as the first phase?
- A. Metabolism
- B. Absorption
- C. Distribution
- D. Excretion
Correct Answer: B
Rationale: Pharmacokinetics refers to the transportation activity of drugs in the body after administration. The first component is absorption. This is followed by distribution, metabolism, and finally excretion.
While receiving treatment for acute pulmonary edema, a woman complains of tinnitus and vertigo.
- A. Clomiphene
- B. Hydrochlorothiazide
- C. Furosemide
- D. Mifepristone
Correct Answer: C
Rationale: Furosemide, a loop diuretic, can cause ototoxicity (tinnitus, vertigo) at high doses.
The nurse admits a patient to the unit and learns the patient has recently been diagnosed with chronic renal failure but has not informed the primary care provider of this diagnosis. What is the nurse's first priority?
- A. Administer medications ordered immediately.
- B. Maintain the patient's confidentiality.
- C. Call the admitting physician immediately.
- D. Provide teaching about chronic renal failure
Correct Answer: C
Rationale: Renal failure affects drug clearance; informing the physician ensures safe therapy adjustments.
A nurse is caring for a client after thyroidectomy and notes that calcium gluconate is prescribed for the client. The nurse determines that this medication has been prescribed to:
- A. Treat thyroid storm.
- B. Prevent cardiac irritability.
- C. Treat hypocalcemic tetany.
- D. Stimulate the release of parathyroid hormone.
Correct Answer: C
Rationale: Hypocalcemia can develop after thyroidectomy if the parathyroid glands are accidentally removed or injured during surgery. Manifestations develop 1 to 7 days after surgery. If the client develops numbness and tingling around the mouth, fingertips, or toes or muscle spasms or twitching, the health care provider is notified immediately. Calcium gluconate should be kept at the bedside.
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.