Which of the following reflects a nurse's responsibility when a drug is prescribed for a client? (Select one that does not apply.)
- A. Administering the drug to the client
- B. Monitoring for therapeutic response
- C. Checking for drug-drug interactions
- D. Reporting adverse reactions
Correct Answer: C
Rationale: When a drug is prescribed to a client, the nurse is responsible for the administration of the drug, monitoring for therapeutic effects, reporting adverse drug reactions, and teaching the client information needed to administer the drug safely at home. A pharmacist checks for drug-drug interactions prior to dispensing a drug for administration.
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The nurse is preparing to administer a prescribed drug to a patient. The patient looks at the tablet and says, 'This doesn't look like my usual pill.' Which response by the nurse would be most appropriate?
- A. This is the same pill your doctor has been ordering.'
- B. It must be from a different manufacturer.'
- C. It looks different? Are you sure?'
- D. Let me double check with your doctor and the order.'
Correct Answer: D
Rationale: If the patient makes any statement about the drug, the nurse needs to hold the drug and investigate the patient's statement, double checking the chart and the order and obtaining clarification and/or confirmation from the prescriber. It may be that the dosage or manufacturer has changed and that is what makes the pill look different. It is always important to err on the side of caution. Telling the patient that the pill is the same or that it is from a different manufacturer may be true, but the nurse needs to confirm that before giving it to the patient. Repeating the patient's statement and then asking him if he is sure is inappropriate because it implies that the patient is incorrect.
A 66-year-old male was prescribed phenelzine (Nardil) while in an acute psychiatric unit for recalcitrant depression. The NP managing his primary health care needs to understand the following regarding phenelzine and other monoamine oxidase inhibitors (MAOIs):
- A. He should not be prescribed any serotonergic drug such as sumatriptan (Imitrex)
- B. MAOIs interact with many common foods, including yogurt, sour cream, and soy sauce
- C. Symptoms of hypertensive crisis (headache, tachycardia, sweating) require immediate treatment
- D. All of the above
Correct Answer: D
Rationale: MAOIs have serotonergic interactions, food restrictions (tyramine), and hypertensive crisis risks.
A nurse at a provider's office is preparing to administer RV, DTaP, Hib, PCV13, and IPV immunizations to a 4-month-old infant. Which of the following actions should the nurse plan to take?
- A. Administer IPV orally
- B. Administer subcutaneous injections in the anterolateral thigh.
- C. Administer IM injections in the deltoid muscle.
- D. Give the infant a phone during vaccine injections.
Correct Answer: B
Rationale: Subcutaneous injections in the thigh and pacifier use are appropriate for a 4-month-old; IPV is IM, not oral.
Ginseng, which is taken to assist with memory, may potentiate:
- A. Aricept
- B. Insulin
- C. Digoxin
- D. Propranolol
Correct Answer: C
Rationale: Ginseng can increase digoxin levels, potentially leading to toxicity.
Where are tight junctions created by two adjoining cells located?
- A. Bone
- B. Brain
- C. Skin
- D. Liver
Correct Answer: B
Rationale: Tight junctions are prominent in the brain (blood-brain barrier), restricting drug entry, unlike the liver (fenestrated) or bone/skin (different barriers).
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