Clinical Procedures and Protocols Flashcards
7 cards from real APC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Clinical Procedures and Protocols flashcards as text
A patient presents with signs of digoxin toxicity (nausea, bradycardia, visual disturbances). Their plasma digoxin level is 3.8 nmol/L. What is the most critical next investigation?
Answer: Serum potassium
Hypokalaemia potentiates digoxin toxicity even at therapeutic levels, making serum potassium the most urgent electrolyte to check and correct.
Which route of administration bypasses first-pass hepatic metabolism and is therefore advantageous for drugs with very high first-pass extraction?
Answer: Sublingual
Sublingual absorption delivers drug directly into the systemic circulation via the lingual veins, completely bypassing hepatic first-pass metabolism.
A pharmacist reviews a new discharge prescription for a post-MI patient. Which combination of medication classes is consistent with evidence-based secondary prevention therapy?
Answer: Aspirin, beta-blocker, ACE inhibitor, and high-intensity statin
Post-MI secondary prevention guidelines recommend aspirin, a beta-blocker, an ACE inhibitor, and high-intensity statin therapy in all eligible patients.
When reconstituting a powdered antibiotic for IV infusion, the pharmacist should add diluent to the powder by which technique to minimise aerosol and foam?
Answer: Direct the stream of diluent against the side of the vial and gently swirl
Directing diluent against the vial wall and swirling gently prevents excessive foam and reduces aerosolisation of the antibiotic powder.
Under the National Inpatient Medication Chart (NIMC) protocol in Australia, which field must be completed by the prescriber for all PRN (as-needed) orders?
Answer: Frequency, maximum dose per episode, and the indication or reason for use
NIMC PRN orders must include frequency, maximum dose, and the clinical indication so nursing staff can make safe and appropriate administration decisions.
What is the primary purpose of performing a 'double-check' procedure for high-alert medications in hospital settings?
Answer: To have two independent clinicians verify the drug, dose, and patient identity before administration
Independent double-checks require two clinicians to separately verify high-alert medication details, reducing the risk of serious administration errors.
A pharmacist notices that a patient prescribed lithium has recently started ibuprofen for knee pain. What is the most likely consequence of this combination?
Answer: Increased lithium levels due to reduced renal prostaglandin synthesis
NSAIDs inhibit renal prostaglandin synthesis, reducing GFR and lithium clearance, which can lead to lithium toxicity.