Nokea
Which statement is true about Lomotil?
- A. Abuse potential for this drug is low
- B. Psychological dependency is likely
- C. There is a high potential for abuse
- D. This drug is not a controlled substance
Correct Answer: A
Rationale: Lomotil, a Schedule V drug, has an abuse potential of limited physical or psychological dependence liability compared with drugs in Schedule IV.
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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, didn't they know this adverse effect could occur? What is the nurse's best response? (Select one that does not apply.)
- A. Pharmaceutical companies sometimes underreport problems to make more money.
- B. Your response to this medication will be reported to the drug company and the Food and Drug Administration (FDA).
- C. After a drug reaches phase III testing it is considered an accepted drug and will not be recalled.
- D. The pharmaceutical company weighs the benefits of the drug with the severity of adverse effects.
Correct Answer: B
Rationale: When a new and unexpected adverse effect occurs, especially one of a serious nature, it is reported to the drug company who reports it to the FDA immediately. When a large number of people begin using the drug in phase III studies, it is not unusual to identify adverse effects not previously noted. It would be both unprofessional and inaccurate to imply that pharmaceutical companies put profit ahead of patient concern because lawsuits would remove any potential profit if a drug proves harmful. The FDA is responsible for weighing risk versus benefit in deciding whether to allow the drug to move to the next phase of testing. Drugs found to have serious adverse effects can be removed from the market at any time.
A 73-year-old male patient is being discharged home today. The discharge order reads: Take 10 mL of guaifenesin (Robitussin) with plastic measuring caps. How much should the nurse teach the client to take at home?
- A. 1/2 tsp
- B. 1 tsp
- C. 2 tsp
- D. 1 tbsp
Correct Answer: C
Rationale: 10 mL equals 2 teaspoons (1 tsp = 5 mL), the correct household measure for patient teaching.
When moving to another state, what is the nurse responsible for becoming familiar with?
- A. Local policies and procedures for controlled substance administration
- B. Local providers Drug Enforcement Agency (DEA) number for prescribing controlled substances
- C. The agency monitoring controlled substances in the new state
- D. Board of Nursing regulations of controlled substances in the new state
Correct Answer: A
Rationale: The nurse needs to learn local policies and procedures for controlled substance administration because they can vary with some local governments more rigorous than others. Nurses do not memorize a providers DEA numbers. The DEA is a federal agency that monitors controlled substances in all states. State boards of nursing do not regulate controlled substances but may regulate how controlled substances are administered by nurses.
Nicotinic receptors are seen in
- A. Skeletal muscle
- B. Visceral smooth muscle
- C. Cardiac muscle
- D. Salivary glands
Correct Answer: A
Rationale: Nicotinic receptors are primarily at skeletal muscle neuromuscular junctions.
A provider may consider testing for CYP2D6 variants prior to starting tamoxifen for breast cancer to:
- A. Ensure the patient will not have increased adverse effects from the tamoxifen
- B. Identify if the patient is a poor metabolizer, potentially reducing conversion to active metabolites
- C. Evaluate risk of drug interactions with tamoxifen
- D. Determine if the patient requires a higher dose due to ultra-rapid metabolism
Correct Answer: B
Rationale: CYP2D6 testing identifies poor metabolizers who may not convert tamoxifen to its active form (endoxifen), impacting efficacy, not just ADRs or interactions .