Nokea
Which medication order requires nursing judgment and means administer if needed?
- A. Morphine 4 mg IV stat
- B. Morphine 4 mg IV prior to procedure
- C. Morphine 4 mg IV four times a day
- D. Morphine 4 mg IV every 4 hours PRN
Correct Answer: D
Rationale: PRN indicates for the nurse to administer morphine every 4 hours if needed and requires nursing judgment. Stat means the dose of morphine would be given immediately, not as needed. The orders for the dose of morphine to be given prior to the patient's scheduled procedure and four times a day, do not indicate to give the dose as needed.
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Digoxin levels need to be monitored closely when the following medication is started:
- A. Loratadine
- B. Diphenhydramine
- C. Ipratropium
- D. Albuterol
Correct Answer: D
Rationale: Albuterol , a beta-agonist, can increase digoxin levels by enhancing its effects, requiring close monitoring; antihistamines and ipratropium have minimal impact.
Medication agreements or 'Pain Medication Contracts' are recommended to be used:
- A. Universally for all prescribing for chronic pain
- B. For patients who have repeated requests for pain medication
- C. When you suspect a patient is exhibiting drug-seeking behavior
- D. For patients with pain associated with malignancy
Correct Answer: A
Rationale: Pain contracts are recommended universally for chronic pain to set expectations, not just for repeated requests , suspicion , or cancer .
Colestipol comes in a powdered form. The patient is taught to:
- A. Take the powder dry and follow it with at least 8 ounces of water
- B. Take it with a meal to enhance its action on fatty food
- C. Mix the powder with 4 to 6 ounces of milk or fruit juice
- D. Take after the evening meal to coincide with cholesterol synthesis
Correct Answer: C
Rationale: Mixing colestipol with liquid improves palatability and administration.
The FDA issued a safety announcement regarding the use of erythropoiesis-stimulating agents (ESAs) in 2010 with the recommendation that:
- A. ESAs no longer be prescribed to patients with chronic renal failure
- B. The risk of tumor development be explained to cancer patients on ESA therapy
- C. Patients should no longer receive ESA therapy to prepare for allogenic transfusions
- D. ESAs be prescribed only to patients staying
Correct Answer: B
Rationale: The 2010 FDA warning highlighted tumor progression risks in cancer patients on ESAs; renal use continues with caution.
A potentially life-threatening adverse response to angiotensin-converting enzyme inhibitors is angioedema. Which of the following statements is true about this adverse response?
- A. Swelling of the tongue or hoarseness are the most common symptoms.
- B. It appears to be related to the decrease in aldosterone production.
- C. Presence of a dry, hacky cough indicates a high risk for this adverse response.
- D. Because it takes time to build up a blood level, it occurs after being on the drug for about 1 week.
Correct Answer: A
Rationale: Angioedema presents with tongue swelling or hoarseness and is not linked to cough or aldosterone.