When writing a prescription for warfarin it is common to write ____ on the prescription.
- A. OK to substitute for generic
- B. The brand name of warfarin and Do Not Substitute
- C. PRN refills
- D. Refills for 1 year
Correct Answer: B
Rationale: Brand-specific warfarin ensures consistent potency; generics vary slightly, and PRN or yearly refills are impractical.
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The nurse, working on the maternity unit, receives a call from a pregnant woman asking how she can know whether a medication is safe to take while pregnant. What is the nurses best response?
- A. You can take any drug indicated as a Category A.
- B. No medications should be taken during pregnancy.
- C. Never take medication until you receive approval from your health care provider.
- D. Most medications are safe but you need to weigh benefit against risk.
Correct Answer: C
Rationale: The best response to a pregnant woman asking about medication usage is to talk with her obstetric practitioner because the best advice will come from someone who knows their health and pregnancy history. While Category A drugs have no known risk, they may be contraindicated by the woman's health condition or pregnancy issues and many pregnant women would not know what it means to be a Category A drug. Medications can be helpful during pregnancy if taken safely and appropriately. Although risk benefit needs to be weighed, it should occur with advice from the obstetric practitioner.
The student nurses are learning to weigh patients and do vital signs. Weighing a client is a nursing intervention that is most important for what?
- A. Dosage calculation
- B. Assessing changes in fluid balance
- C. Assessing changes in nutritional status
- D. Caloric needs
Correct Answer: B
Rationale: Weighing assesses fluid balance changes, vital for adjusting drugs like diuretics in conditions such as CHF.
Precautions that should be taken when prescribing controlled substances include:
- A. Faxing the prescription for a Schedule II drug directly to the pharmacy
- B. Using tamper-proof paper for all prescriptions written for controlled drugs
- C. Keeping any pre-signed prescription pads in a locked drawer in the clinic
- D. Using only numbers to indicate the amount of drug to be prescribed
Correct Answer: B
Rationale: Tamper-proof paper prevents fraud, a key precaution; faxing Schedule II has restrictions, and locking pads or numbers-only are less specific.
A nurse is caring for a client who has Atrial Fibrillation and a new prescription for Dabigatran to prevent development of Thrombosis. Which of the following medications is prescribed concurrently to treat an adverse effect of Dabigatran?
- A. Vitamin k1
- B. Protamine
- C. Omeprazole
- D. Probenecid
Correct Answer: C
Rationale: Omeprazole reduces dabigatran's GI bleeding risk, a common side effect.
Which route of drug administration is most likely to lead to first pass effect?
- A. Sublingual
- B. Oral
- C. Intravenous
- D. Intramuscular
Correct Answer: B
Rationale: Oral administration subjects drugs to the first-pass effect, where they are metabolized by the liver via the portal vein before reaching systemic circulation, reducing bioavailability.
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