Nokea
Which of the following two cyclooxygenase isoenzymes is constitutively expressed?
- A. COX-1
- B. COX-2
Correct Answer: A
Rationale: COX-1 is constitutively expressed in most tissues, maintaining normal functions, unlike inducible COX-2.
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Incorporating information technology (IT) into a patient encounter takes skill and tact. During the encounter, the provider can make the patient more comfortable with the IT the provider is using by:
- A. Turning the screen around so the patient can see material being recorded
- B. Not placing the computer screen between the provider and the patient
- C. Both 1 and 2
- D. Neither 1 nor 2
Correct Answer: C
Rationale: Both actions reduce barriers and enhance patient comfort with IT use.
Bethanechol:
- A. Increases detrusor muscle tone to empty the bladder
- B. Decreases gastric acid secretion to treat peptic ulcer disease
- C. Stimulates voluntary muscle tone to improve strength
- D. Reduces bronchial airway constriction to treat asthma
Correct Answer: A
Rationale: Bethanechol, a cholinergic, increases detrusor tone for bladder emptying.
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.
The nurse is reviewing the history and physical examination of a client who will be receiving asparaginase (Elspar), an antineoplastic agent. The nurse consults with the registered nurse regarding the administration of the medication if which of the following is documented in the client's history?
- A. Pancreatitis
- B. Diabetes mellitus
- C. Myocardial infarction
- D. Chronic obstructive pulmonary disease
Correct Answer: A
Rationale: Asparaginase (Elspar) is contraindicated if hypersensitivity exists, in pancreatitis, or if the client has a history of pancreatitis. The medication impairs pancreatic function and pancreatic function tests should be performed before therapy begins and when a week or more has elapsed between administration of the doses. The client needs to be monitored for signs of pancreatitis, which include nausea, vomiting, and abdominal pain. The conditions noted in options 2, 3, and 4 are not contraindicated with this medication.
Drug levels should be monitored in the treatment of
- A. Diabetes
- B. Epilepsy
- C. Status Asthmatics
- D. Hypertension
Correct Answer: B
Rationale: Therapeutic drug monitoring is critical in epilepsy (e.g., phenytoin) due to narrow therapeutic ranges.