A patient receives a drug that has a narrow therapeutic range. The nurse administering this medication will expect to do what?
Administer the drug at intervals longer than the drug half-life.
Teach the patient that maximum drug effects will occur within a short period.
Administer this medication intravenously.
Order lab to check blood drug level.
The Correct Answer is D
Choice A Reason:
Administering the drug at intervals longer than the drug half-life is not typically recommended for medications with a narrow therapeutic range. These drugs require precise dosing to maintain therapeutic levels without reaching toxic levels. Extending the dosing interval could lead to subtherapeutic levels, reducing the drug’s effectiveness.
Choice B Reason:
Teaching the patient that maximum drug effects will occur within a short period is not specific to drugs with a narrow therapeutic range. While some medications may have rapid onset of action, the critical aspect of narrow therapeutic range drugs is maintaining consistent blood levels to avoid toxicity or subtherapeutic effects.
Choice C Reason:
Administering the medication intravenously is not a requirement for all drugs with a narrow therapeutic range. While IV administration can provide precise control over drug levels, many narrow therapeutic range drugs can be administered orally or through other routes. The key is monitoring and adjusting the dose based on blood levels.
Choice D Reason:
Ordering lab tests to check blood drug levels is essential for managing medications with a narrow therapeutic range. These drugs have a small margin between therapeutic and toxic doses, so regular monitoring of blood levels helps ensure the drug remains within the safe and effective range. This practice is known as therapeutic drug monitoring (TDM) and is crucial for drugs like warfarin, phenytoin, and digoxin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
Increased neuromuscular excitability is not typically associated with respiratory acidosis. Instead, respiratory acidosis can lead to symptoms such as confusion, fatigue, and shortness of breath due to the buildup of carbon dioxide in the blood. Neuromuscular excitability is more commonly associated with conditions like hypocalcemia.
Choice B Reason:
This is the correct answer. Respiratory acidosis occurs when the lungs cannot remove enough carbon dioxide (CO2) from the body, leading to an accumulation of CO2 in the blood. This increase in CO2 results in the formation of carbonic acid, which lowers the pH of the blood. The elevated levels of carbonic acid are a hallmark of respiratory acidosis.
Choice C Reason:
Increased pH is not associated with respiratory acidosis. In fact, respiratory acidosis is characterized by a decrease in blood pH due to the accumulation of carbon dioxide and the subsequent increase in carbonic acid. Therefore, this choice is incorrect.
Choice D Reason:
Hypokalemia, or low potassium levels, is not typically associated with respiratory acidosis. Instead, respiratory acidosis can sometimes lead to hyperkalemia (high potassium levels) due to the shift of potassium out of cells in response to the acidotic state. Therefore, this choice is incorrect.
Correct Answer is B
Explanation
Choice A Reason:
Inducer medications do not increase the blood level of newly added medications. Instead, they enhance the activity of enzymes that metabolize drugs, leading to a faster breakdown and lower concentration of the new medication in the bloodstream. This can result in reduced efficacy of the newly added medication.
Choice B Reason:
Inducer medications increase the activity of enzymes, particularly those in the cytochrome P450 family, which are responsible for drug metabolism. This increased enzyme activity accelerates the breakdown of the newly added medication, thereby decreasing its blood level and potentially reducing its therapeutic effect. For example, rifampin is a well-known inducer that can significantly lower the levels of drugs metabolized by CYP3A4.
Choice C Reason:
Inducer medications do not increase the half-life of newly added medications. On the contrary, by enhancing the metabolic activity of enzymes, they typically reduce the half-life of the new medication. This means the drug is broken down and eliminated from the body more quickly.
Choice D Reason:
Inducer medications do have a significant effect on new medications. They alter the metabolism of drugs by increasing the activity of metabolic enzymes, which can lead to decreased blood levels and reduced effectiveness of the new medication. Ignoring this interaction can result in subtherapeutic drug levels and treatment failure.
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