Nokea
Which action will the nurse take if a dosage is unclear on a health care provider's order?
- A. Ask the patient what dosage was given in the past.
- B. Ask another physician to determine the correct dosage.
- C. Tell the patient that the medication will not be given.
- D. Contact the health care provider to verify the correct dosage.
Correct Answer: D
Rationale: Any questionable orders should be verified by the health care provider who wrote the orders. The patient is not a reliable source of verification. The physician who wrote the order should verify it. It would be a medication error to withhold the dose instead of verifying it.
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Prior to prescribing metformin, the provider should:
- A. Draw a serum creatinine to assess renal function
- B. Try the patient on insulin
- C. Tell the patient to increase iodine intake
- D. Have the patient stop taking any sulfonylurea to avoid dangerous drug interactions
Correct Answer: A
Rationale: Metformin requires renal function assessment (creatinine) due to lactic acidosis risk; insulin isn't a prerequisite.
Off-label prescribing is:
- A. Regulated by the U.S. Food and Drug Administration
- B. Illegal by NPs in all states (provinces)
- C. Legal if there is scientific evidence for the use
- D. Regulated by the Drug Enforcement Administration
Correct Answer: C
Rationale: Off-label prescribing is legal with scientific support , not FDA-regulated , universally illegal , or DEA-controlled .
Which of the following is a representative of sulfonylurea?
- A. Metformin
- B. Sitagliptine
- C. Acarbose
- D. Chlorpropamide
Correct Answer: D
Rationale: Chlorpropamide is a sulfonylurea that stimulates insulin release from pancreatic beta cells.
The factors contributing to the unequal distribution of drugs are all except:
- A. Heterogenesity of the drug
- B. Binding to plasma proteins
- C. Cellular binding
- D. Concentration in body fat
Correct Answer: A
Rationale: Unequal distribution is due to physiological factors like plasma protein binding, cellular binding, fat concentration, and barriers (e.g., blood-brain barrier), not drug heterogeneity.
The nurse is caring for a patient who had a severe, acute, previously unseen adverse effect of a drug in Phase III testing. The patient asks, After all the testing done on this drug, didnt they know this adverse effect could occur? What is the nurses best response? (Select all that apply.)
- A. Phase III testing involves wide-scale population testing, which can reveal rare adverse effects not seen in earlier phases.
- B. New adverse effects can lead to further study or withdrawal of the drug.
- C. Phase I testing on healthy volunteers ensures all adverse effects are identified before patient use.
- D. Even with extensive testing, some adverse effects may only appear after widespread use.
Correct Answer: C
Rationale: Phase III testing involves a large population, uncovering rare effects . Preclinical animal studies don't fully predict human responses (B is false). Phase I uses healthy volunteers, missing disease-specific effects (C is false). Rare effects emerge post-approval , potentially leading to further action .