1. A 45-year-old client with type I diabetes is in need of support services upon discharge from a skilled rehabilitation unit. Which of the following services is an example of a skilled support service?
A) shopping for groceries B) house cleaning C) transportation to physician - s visits D) medication instruction
2. Narrow therapeutic index medications:
A) are drug formulations with limited pharmacokinetic variability. B) have limited value and require no monitoring of blood levels. C) have less than a twofold difference in minimum toxic levels and minimum effective concentration in the blood. D) have limited potency and side effects.
3. A client can receive the mumps, measles, rubella (MMR) vaccine if he or she:
A) is pregnant. B) is immunocompromised. C) is allergic to neomycin. D) has a cold.
4. A chemical reaction between drugs prior to their administration or absorption is known as:
A) a drug incompatibility. B) a side effect. C) an adverse event. D) an allergic response.
5. A client is given an opiate drug for pain relief following general anesthesia. The client becomes extremely somnolent with respiratory depression. The physician is likely to order the administration of:
A) naloxone (Narcan). B) labetalol (Normodyne). C) neostigmine (Prostigmin). D) thiothixene (Navane).
1. Right Answer: D Explanation: The only skilled service listed is medication instruction. Grocery shopping, house-cleaning services, and transportation services are all examples of unskilled services offered by volunteer and fee-for-service agencies.Coordinated Care
2. Right Answer: C Explanation: The therapeutic index is the ratio between the median lethal dose and median effective dose of a drug. It provides a general indication of the margin of safety of a drug. Choice 1 is incorrect because pharmacokinetics is the process of adsorption, distribution, metabolism, and elimination. Choice 2 is incorrect because narrow therapeutic index drugs require close monitoring since there is often little difference between the desired drug effect and toxicity. Choice 4 is incorrect because narrow therapeutic index have the potential for severe toxic effects with only slight increases in the dose or slight decreases in elimination. PharmacologicalTherapies
3. Right Answer: D Explanation: A simple cold without fever does not preclude vaccination. Choices 1 and 2 are incorrect because pregnant women and immunocompromised individuals cannot have the MMR vaccine because the rubella component is a live virus and might cause birth defects and/or disease. Choice 3 is incorrect because the AmericanAcademy of Pediatrics states, 'Persons who have experienced anaphylactic reactions to topically or systemically administered neomycin should not receive measles vaccine.' Pharmacological Therapies
4. Right Answer: A Explanation: This occurs most often when drug solutions are combined before they are given intravenously but can occur with orally administered drugs as well. Choices 2, 3, and 4 are incorrect because drugs can cause these events after administration and absorption. Pharmacological Therapies
5. Right Answer: A Explanation: Naloxone is an opiate antagonist. It attaches to opiate receptors and blocks or reverses the action of narcotic analgesics. Choice 2 is incorrect because Labetalol is a beta blocker. Choice 3 is incorrect because Neostigmine is an anticholinesterase agent. Choice 4 is incorrect because Thiothixene is an antipsychotic agent.Pharmacological Therapies
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