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WGU D116 COMPREHENSIVE ASSESSMENT: QUESTIONS WITH SOLUTIONS WITH EXPLANATIONS
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WGU D116 COMPREHENSIVE ASSESSMENT: QUESTIONS WITH SOLUTIONS WITH EXPLANATIONS
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WGU D116 COMPREHENSIVE ASSESSMENT: QUESTIONSWITH SOLUTIONS WITH EXPLANATIONS
Which factors could be attributed to limited prescriptive authority for APRNs?
Select all that apply. Right Ans - Inaccessibility of patient care
Feedback: Limiting prescriptive authority for APRNs can create barriers to
quality, affordable, and accessible patient care. It may also lead to poor
collaboration among providers and higher health care costs. It would not
directly impact patient's health literacy.
Higher health care costs
Feedback: Limiting prescriptive authority for APRNs can create barriers to
quality, affordable, and accessible patient care. It may also lead to poor
collaboration among providers and higher health care costs. It would not
directly impact patient's health literacy.
A patient reports that a medication prescribed for recurrent migraine
headaches is not working. Which action should be taken first? Right Ans -
Ask the patient about the number and frequency of tablets taken
Feedback: using the drug as ordered. Asking the patient to tell the nurse how
many tablets are taken and how often helps the nurse determine compliance.
Assessing current pain does not yield information about how well the
medication is working unless the patient is currently taking it. The nurse
should gather as much information about compliance, symptoms, and drug
effectiveness as possible before contacting the prescriber. Biofeedback may be
an effective adjunct to treatment, but it should not be recommended without
complete information about drug effectiveness
A patient is receiving intravenous gentamicin. A serum drug test reveals toxic
levels. The dosing is correct, and this medication has been tolerated bythis
patient inthe past. Which could be a probable cause of the test result? Right
Ans - The patient is taking another medication that binds to serum albumin
Feedback: Gentamicin binds to albumin, but only weakly, and in the presence
of another drug that binds to albumin, it can rise to toxic levels in blood
serum. A loading dose increases the initial amount ofa drug and is used to
bring drug levels to the desired plateau more quickly. A drug that is not
completely dissolved carries a risk of causing embolism. A drug given at a
frequency longer than the drug half-life will likely be at subtherapeutic levels
and not at toxic levels
,The nurse is administering morning medications. The nurse gives a patient
multiple medications, two of which compete for plasma albumin receptor
sites. As a result of this concurrent administration, the nurse can anticipate
that what might occur? Select all that apply Right Ans - Binding of one or
both agents will be reduced
Plasma levels of free drug will rise
The increase in free drug will intensify effects
Feedback: When two drugs bind to the same site on plasma albumin,
coadministration of those drugs produces competition for binding. As a result,
binding of one or both agents is reduced, causing plasma levels of free drug to
rise. The increase in free drug can intensify the effect, but it usually undergoes
rapid elimination. The increase in plasma levels of free drug is rarely
sustained.
Which patients are at increased risk for adverse drug events? Select all that
apply Right Ans - A 2-month-old infant taking a medication for
gastroesophageal reflux disease
A 40-year-old male who is intubated in the intensive care unit and taking
antibiotics and cardiac medications
A 7-year-old female receiving insulin for diabetes
An 80-year-old male taking medications for COPD
Feedback: Patients at increased risk for adverse drug events include the very
young, the very old, and those who have serious illnesses. Females, children,
and young adults taking single medications do not have increased risk for
adverse events.
A patient asks a nurse why a friend who is taking the same drug responds
differently to that drug. The nurse knows that the most common variation in
drug response is due to differences in each patient's: Right Ans -
metabolism of drugs
Feedback: The most common source of genetic variation in drug response is
related to alterations in drug metabolism and is determined by genetic codes
for various drug-metabolizing isoenzymes. There are known genetic
differences in codes for drug target sites, but these are not as numerous
asthose for metabolic isoenzymes. Hypersensitivity potential is also
genetically determined, but variations produce differences in adverse
reactions to drugs and not in drug effectiveness. Psychosocial responses vary
, for many less measurable reasons, such as individual personalities and
variations in cultures
A patient with migraines is started on a beta blocker. The nurse explains the
benefits of taking the medication for migraines. Which statement by the
patient indicates an understanding of the medication's effects? Right Ans -
"I need to take it every day to reduce the frequency of migraines."
Feedback: When taken prophylactically, medications such as beta blockers
can reduce the frequency of migraine attacks. They do not provide complete
relief from migraines. They do not reduce the duration of migraines. They are
not effective for treating a migraine once the migraine has begun
A prescriber orders transdermal clonidine [Catapres TTS] for a patient with
hypertension. What will the nurse teach this patient? Right Ans - To change
the patch every week
Feedback: Transdermal patches are to be changed every 7 days. Medication
administered by patch has the same therapeutic effect and adverse effects
asthat given by other routes, except that localized skin reactions may occur
and are common with clonidine patches. The patch should be applied to intact,
hairless skin on the upper arm or torso
A psychiatric nurse is teaching a patient about an antidepressant medication.
The nurse tells the patient that therapeutic effects may not occur for several
weeks. The nurse understands that this is likely the result of: Right Ans -
changes in the brain as a result of prolonged drug exposure
Feedback: It is thought that beneficial responses to central nervous system
(CNS) drugs are delayed because they result from adaptive changes as the CNS
modifies itself in response to prolonged drug exposure, and that the responses
are not the result of the direct effects of the drugs on synaptic functions. The
blood-brain barrier prevents protein-bound and highly ionized drugs from
crossing into the CNS, but it does not slow the effects of drugs that can cross
the barrier. Tolerance is a decreased response to a drug after prolonged use
A 25-year-old patient has been newly diagnosed with Parkinson disease, and
the prescriber is considering using pramipexole [Mirapex]. Before beginning
therapy with this drug, the nurse will ask the patient about: Right Ans - any
history of alcohol abuse or compulsive behaviors
Feedback: Pramipexole has been associated with impulse control disorders,
and this risk increases in patients with a history of alcohol abuse or
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