Nokea
When taking a medication history on a patient why should the nurse ask about the use of complementary or alternative therapies?
- A. Patients starting on new drugs are usually not compliant with medical regimens.
- B. Many drug-alternative therapy interactions can cause serious problems.
- C. Natural products may be more effective and the prescribed drug may not be needed.
- D. The cost of the drug and the alternative therapy may be too expensive for the patient to hand
Correct Answer: B
Rationale: Complementary therapies can interact with prescribed drugs, posing risks that the nurse must identify.
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Henry is 82 years old and takes two aspirin every morning to treat the arthritis pain in his back. He states the aspirin helps him to 'get going' each day. Lately he has had some heartburn from the aspirin. After ruling out an acute GI bleed, what would be an appropriate course of treatment for Henry?
- A. Add an H2 blocker such as ranitidine to his therapy
- B. Discontinue the aspirin and switch him to Vicodin for the pain
- C. Decrease the aspirin dose to one tablet daily
- D. Have Henry take an antacid 15 minutes before taking the aspirin each day
Correct Answer: A
Rationale: An H2 blocker reduces aspirin-induced heartburn; stopping or antacids don't address chronic use.
Which of the following is used for the treatment of primary hyperaldosteronism:
- A. Furosemide
- B. Hydrocortisone
- C. Spironolactone
- D. Dexamethasone
Correct Answer: C
Rationale: Spironolactone is an aldosterone antagonist, making it effective for treating primary hyperaldosteronism by blocking excess aldosterone effects.
Prophylactic use of bisphosphonates is recommended for patients with early osteopenia related to long-term use of which of the following drugs?
- A. Selective estrogen receptor modulators
- B. Aspirin
- C. Glucocorticoids
- D. Calcium supplements
Correct Answer: C
Rationale: Glucocorticoids cause bone loss, warranting bisphosphonate prophylaxis; SERMs protect bone.
What concept is considered when generic drugs are substituted for brand name drugs?
- A. Bioavailability
- B. Critical concentration
- C. Distribution
- D. Half-life
Correct Answer: A
Rationale: Bioavailability is the portion of a dose of a drug that reaches the systemic circulation and is available to act on body cells. Binders used in a generic drug may not be the same as those used in the brand name drug. Therefore, the way the body breaks down and uses the drug may differ, which may eliminate a generic drug substitution. Critical concentration is the amount of a drug that is needed to cause a therapeutic effect and should not differ between generic and brand name medications. Distribution is the phase of pharmacokinetics, which involves the movement of a drug to the body's tissues and is the same in generic and brand name drugs. A drug's half-life is the time it takes for the amount of drug to decrease to half the peak level, which should not change when substituting a generic medication.
Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When applying the medication, the client complains of local discomfort and burning. Which of the following is the most appropriate nursing action?
- A. Notifying the registered nurse
- B. Discontinuing the medication
- C. Informing the client that this is normal
- D. Applying a thinner film than prescribed to the burn site
Correct Answer: C
Rationale: Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms and is used to treat burns to reduce bacteria present in avascular tissues. The client should be informed that the medication will cause local discomfort and burning and that this is a normal reaction; therefore options 1, 2, and 4 are incorrect.