Nokea
You are discussing your patient's drug regimen with their primary care provider. The patient has seen two specialists since seeing the primary care provider and been diagnosed with renal impairment. Why would this be important information? (Select one that does not apply.)
- A. Help promote a safe and effective medication regimen
- B. Help prevent medication errors
- C. So the physician can answer family questions
- D. Help prevent adverse effects
Correct Answer: C
Rationale: Renal impairment affects drug clearance, making this information vital to prevent errors , adverse effects , and ensure safety/efficacy . Keeping everyone informed and answering family questions are secondary.
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The nurse is aware that for a drug to work properly on reactive tissues, a sufficient amount of the drug is needed to cause the therapeutic effect. The term used for this amount is:
- A. Critical concentration
- B. Dynamic equilibrium
- C. Selective toxicity
- D. Active transport
Correct Answer: A
Rationale: A critical concentration of a drug must be present before a reaction occurs within our cells. A dynamic equilibrium is obtained from absorption of a drug from the site of drug entry, distribution to the active site, metabolism in the liver, and excretion from the body to have a critical concentration. Selective toxicity is the ability of a drug to attach only to those systems found in foreign cells. Active transport is the process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney.
Immunomodulators such as azathioprine may cause a delayed adverse drug reaction known as a type D reaction because they are known:
- A. Teratogens
- B. Carcinogens
- C. To cause hypersensitivity reactions
- D. Hypothalamus-pituitary-adrenal axis suppressants
Correct Answer: B
Rationale: Azathioprine's Type D (delayed) ADRs, like cancer risk , emerge long-term, unlike teratogenicity , hypersensitivity , or HPA suppression .
When prescribing NSAIDS, a complete drug history should be conducted as NSAIDs interact with these drugs:
- A. Omeprazole, a proton pump inhibitor
- B. Combined oral contraceptives
- C. Diphenhydramine, an antihistamine
- D. Warfarin, an anticoagulant
Correct Answer: D
Rationale: NSAIDs increase bleeding risk with warfarin; interactions with PPIs or contraceptives are less significant.
Both men and women experience bone loss with aging. The bones most likely to demonstrate significant loss are:
- A. Cortical bones
- B. Femoral neck bones
- C. Cervical vertebrae
- D. Pelvic bones
Correct Answer: B
Rationale: Femoral neck is a trabecular bone site prone to significant age-related loss, unlike cortical or other areas .
Desmopressin acetate (DDAVP) is prescribed for the treatment of diabetes insipidus. The nurse monitors the client after medication administration for which therapeutic response?
- A. Decreased urinary output
- B. Decreased blood pressure
- C. Decreased peripheral edema
- D. Decreased blood glucose level
Correct Answer: A
Rationale: Desmopressin promotes renal conservation of water. The hormone carries out this action by acting on the collecting ducts of the kidney to increase their permeability to water, which results in increased water reabsorption. The therapeutic effect of this medication would be manifested by a decreased urine output. Options 2, 3, and 4 are unrelated to the effects of this medication.