Nokea
Which of the following would the nurse identify as a factor that alters drug response in children and infants? (Select one that does not apply.)
- A. Slower gastric emptying
- B. Greater surface area
- C. Less protein binding
- D. Decreased body water content
Correct Answer: D
Rationale: Children and infants are not small adults; therefore, they have altered pharmacokinetics. Factors that alter pharmacokinetics in children include slower gastric emptying, less cutaneous fat, greater surface area, increased body water content, less protein binding, and immature hepatic and renal function.
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Which of the following is not a dose related reaction:
- A. Myocardial Irritation of Quinidine
- B. Hypoglycemia of tolbutamide
- C. Digitalis induced arrythmia
- D. Drug fever of sulpha
Correct Answer: D
Rationale: Drug fever from sulfa is an idiosyncratic/hypersensitivity reaction, not dose-related.
The nurse, providing patient teaching about home medication use to an older adult, explains that even when drugs are taken properly they can produce negative or unexpected effects. What are these negative or unexpected effects called?
- A. Teratogenic effects
- B. Toxic effects
- C. Adverse effects
- D. Therapeutic effects
Correct Answer: C
Rationale: Negative or unexpected effects are known as adverse or side effects. Teratogenic effects are adverse effects on the fetus and not a likely concern for an older adult. Toxic effects occur when medication is taken in larger than recommended dosages caused by an increase in serum drug levels. Therapeutic effects are the desired actions for which the medication is prescribed.
A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes isotretinoin. The nurse reviews the client's medication record and would contact the (HCP) if the client is taking which medication?
- A. Vitamin A
- B. Digoxin (Lanoxin)
- C. Furosemide (Lasix)
- D. Phenytoin (Dilantin)
Correct Answer: A
Rationale: Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A supplements should be discontinued before isotretinoin therapy. Options 2, 3, and 4 are not contraindicated with the use of isotretinoin.
Which of the following statements about beta-blockers is false?
- A. Beta-blockers should be avoided with non-dihydropyridine calcium channel blockers
- B. Beta-blockers increase renin secretion
- C. Non-selective beta-blockers are contraindicated in asthma
- D. Beta-blockers prolong the refractory period of the AV node
Correct Answer: B
Rationale: Beta-blockers decrease renin secretion by blocking beta-1 receptors in the kidney, making this statement false.
Identify potential drug-drug interactions that may occur with tamoxifen
- A. Not provided in document
- B. Not provided in document
- C. Not provided in document
- D. Not provided in document
Correct Answer: D
Rationale: This question lacks options in the document, but based on the answer key (ANS: 4), it is assumed to correspond to the fourth choice if options were present. Tamoxifen has significant interactions with CYP2D6 inhibitors (e.g., SSRIs), which can reduce its efficacy.