Exam (elaborations)
D116 WGU COMPREHENSIVE ASSESSMENT WITH EXPLANATIONS
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D116 WGU COMPREHENSIVE ASSESSMENT WITH EXPLANATIONS
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D116 WGU COMPREHENSIVE ASSESSMENT WITHEXPLANATIONS
Which factors could be attributed to limited prescriptive authority for
APRNs?Select all that apply.
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?
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?
,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
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
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:
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?
“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?
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
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