Nursing Elites

1. When administering medications to a 4-month-old infant, which of the following pharmacokinetic principles should be considered? (Select all that apply.)

• A. Infants have a more rapid gastric emptying time.
• B. Infants have immature liver function.
• C. Infants' blood-brain barrier is poorly developed.
• D. Infants have an increased ability to absorb topical medications.

Correct answer: B

Rationale: When administering medications to a 4-month-old infant, the pharmacokinetic principle to consider is that infants have immature liver function until 1 year of age. This requires medications metabolized by the liver to be administered in smaller dosages. While infants do have a more rapid gastric emptying time, immature liver function is a more critical pharmacokinetic consideration in this context. Additionally, although infants have a poorly developed blood-brain barrier, this relates more to pharmacodynamic effects rather than pharmacokinetic principles. The statement about infants having an increased ability to absorb topical medications is not directly related to pharmacokinetic principles, making choice B the correct answer.

2. What is the correct definition of drug absorption?

• A. Movement of a drug from the site of administration to various tissues of the body
• B. Describes the absorption, distribution, metabolism, and excretion of drugs
• C. These types of drugs can be taken over the counter
• D. This addresses how various drugs affect different forms of the body

Correct answer: A

Rationale: The correct definition of drug absorption is the movement of a drug from the site of administration into various tissues of the body. It is the process by which a drug is taken up and enters the systemic circulation. Choice B describes the pharmacokinetics of drugs, including absorption, distribution, metabolism, and excretion, but it is not a specific definition of drug absorption. Choice C is unrelated to drug absorption, as it refers to over-the-counter drugs. Choice D is too vague and does not specifically address the process of drug absorption.

3. A client with a history of preterm labor is reviewing a new prescription for Terbutaline. Which of the following client statements indicates understanding of the teaching?

• A. I will increase my daily fluid intake to 3 quarts.
• B. I can increase my activity now that I've started on this medication.
• C. I will report increasing intensity of contractions to my doctor.
• D. I am glad this will prevent preterm labor.

Correct answer: C

Rationale: The correct answer is C. The client should report increasing intensity, frequency, or duration of contractions to the provider because these are manifestations of preterm labor. This response demonstrates the client's understanding of the importance of monitoring contractions and seeking appropriate medical attention. Choices A, B, and D are incorrect because increasing fluid intake, increasing activity, or assuming the medication will prevent preterm labor are not relevant actions in managing preterm labor or taking Terbutaline.

4. A client with active tuberculosis asks why he must take four different medications. Which of the following responses should the nurse make?

• A. Four medications decrease the risk of a severe allergic reaction.
• B. Four medications reduce the chance that the bacteria will become resistant.
• C. Four medications reduce the risk of adverse reactions.
• D. Four medications decrease the chance of having a positive tuberculin skin test.

Correct answer: B

Rationale: The correct answer is B. When treating tuberculosis, using a combination of medications is crucial to reduce the risk of bacteria developing resistance to any single drug. This approach helps prevent treatment failure and ensures successful treatment outcomes. Choice A is incorrect because the primary purpose of using multiple medications is not related to allergic reactions. Choice C is incorrect as the risk reduction is mainly focused on bacterial resistance rather than adverse reactions. Choice D is not relevant as the purpose of taking multiple medications is not to affect the tuberculin skin test results.

5. A healthcare professional is preparing to administer Filgrastim for the first time to a client who has just undergone a bone marrow transplant. Which of the following interventions is appropriate?

• A. Administer subcutaneously in a large muscle mass to prevent injury.
• B. Ensure that the medication is kept at room temperature until just prior to administration.
• C. Invert vial gently to mix well before withdrawing dose.
• D. Discard vial after removing one dose of the medication.

Correct answer: D

Rationale: The correct intervention when preparing to administer Filgrastim is to discard the vial after removing one dose of the medication. This practice helps prevent contamination and ensures the medication's effectiveness. Reusing the vial can lead to contamination and compromise the sterility of the medication, putting the client at risk. Therefore, it is crucial to follow proper aseptic technique and discard the vial after withdrawing the prescribed dose.

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