Nokea
You are to infuse 1,200 mL of IV fluid over 6 hours using a drop factor of 10 gtt/mL. What is the flow rate in drops per minute?
- A. 30 gtt/min
- B. 33 gtt/min
- C. 40 gtt/min
- D. 50 gtt/min
Correct Answer: B
Rationale: Flow rate = (1,200 mL 10 gtt/mL) ÷ (6 60) = 12,000 ÷ 360 = 33.33 gtt/min, rounded to 33 gtt/min.
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There is evidence that dietary supplementation or adequate intake of fish oils and omega-3 fatty acids have well-documented:
- A. Concern for developing cardiac dysrhythmias
- B. Anti-inflammatory effects
- C. Total cholesterol-lowering effects
- D. Effects on fasting blood sugar
Correct Answer: B
Rationale: Omega-3 fatty acids have proven anti-inflammatory effects, beneficial in cardiovascular health.
The patient, diagnosed with cancer, is receiving morphine sulfate (a potent narcotic pain reliever) to relieve cancer pain. Approximately every 7 days the medication is no longer effective in controlling the patient's pain and a larger dose is needed to have the same effect. How might the nurse explain why this is happening?
- A. Tolerance
- B. Cumulation
- C. Interactions
- D. Addiction
Correct Answer: A
Rationale: The body may develop a tolerance to some drugs over time. Tolerance may arise because of increased biotransformation of the drug, increased resistance to its effects, or other pharmacokinetic factors. When tolerance occurs, the amount of the drug no longer causes the same reaction. Therefore, increasingly larger doses are needed to achieve a therapeutic effect. Cumulative effect occurs when the drug is not properly eliminated and more of the drug is administered, resulting in toxic levels accumulating. Interactions occur when the drug reacts badly with another substance such as food, another drug, or an alternative or complementary therapy. Addiction is the psychological need for a substance.
A nurse is caring for a patient who is supposed to receive two drugs at the same time. What is the nurses priority action?
- A. Wash her hands before handling the medications.
- B. Consult a drug guide for compatibility.
- C. Question the patient concerning drug allergies.
- D. Identify the patient by checking the armband and asking the patient to state his name.
Correct Answer: B
Rationale: A nurse should first consult a drug guide for compatibility when two or more drugs are being given at the same time. After compatibility is determined the medication can be administered. The nurse will perform hand hygiene, check for patient allergies, and ensure the right patient receives the medication by using two identifiers.
Up to 21% of Asians are ultra-rapid 2D6 metabolizers, requiring:
- A. A need to monitor drugs metabolized by 2D6 for toxicity
- B. Increased dosages needed of drugs metabolized by 2D6, such as the selective serotonin reuptake inhibitors
- C. Decreased conversion of codeine to morphine by CYP 2D6
- D. The need for lowered dosages of drugs, such as beta blockers
Correct Answer: B
Rationale: Ultra-rapid 2D6 metabolizers (e.g., in Asians) need higher SSRI doses due to fast metabolism, unlike toxicity , codeine issues , or lower doses .
A 73-year-old male patient is being discharged home today. The discharge order reads: Take 10 mL of guaifenesin (Robitussin) PO q4h. This over-the-counter pharmaceutical comes in bottles with plastic measuring caps. How much should the nurse teach the patient 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 (5 mL = 1 tsp), so the patient should take 2 tsp per dose.