DHA Nursing Pharmacology & Drug Administration 2 — Questions and Answers
Question 1: A patient on heparin infusion has an aPTT of 200 seconds (therapeutic range 60–100 seconds). What is the priority nursing action?
- Hold the heparin infusion and notify the physician immediately (Correct answer)
- Increase the heparin infusion rate
- Administer vitamin K
- Ignore the result and recheck in 6 hours
Correct answer: Hold the heparin infusion and notify the physician immediately
An aPTT of 200 seconds is significantly supratherapeutic, indicating a high bleeding risk; the infusion must be stopped and the physician notified for dose adjustment.
Question 2: Which class of medications requires the nurse to monitor for signs of angioedema as a rare but serious side effect?
- ACE inhibitors (e.g., lisinopril) (Correct answer)
- Beta-blockers
- Statins
- Thiazide diuretics
Correct answer: ACE inhibitors (e.g., lisinopril)
ACE inhibitors can cause bradykinin accumulation, which in rare cases leads to angioedema—potentially life-threatening swelling of the face, lips, and airway.
Question 3: Insulin glargine (Lantus) is classified as which type of insulin?
- Long-acting basal insulin (Correct answer)
- Rapid-acting insulin
- Intermediate-acting insulin
- Short-acting regular insulin
Correct answer: Long-acting basal insulin
Insulin glargine is a long-acting basal insulin with a relatively flat, peakless profile lasting approximately 24 hours, used to control fasting blood glucose.
Question 4: A nurse notes that a prescribed medication has a narrow therapeutic index. What does this mean clinically?
- The difference between the therapeutic dose and the toxic dose is small, requiring careful monitoring (Correct answer)
- The drug is safe at any dose
- Only one dose per day is required
- The drug has no side effects
Correct answer: The difference between the therapeutic dose and the toxic dose is small, requiring careful monitoring
A narrow therapeutic index means the effective and toxic plasma concentrations are close together, requiring frequent monitoring of drug levels and patient response.
Question 5: Which drug interaction is a contraindication when a patient is taking a monoamine oxidase inhibitor (MAOI)?
- Tyramine-rich foods and sympathomimetic drugs (Correct answer)
- Vitamin C supplements
- Paracetamol (acetaminophen)
- Standard saline IV fluids
Correct answer: Tyramine-rich foods and sympathomimetic drugs
MAOIs inhibit the breakdown of tyramine and catecholamines; consuming tyramine-rich foods or sympathomimetics can trigger a hypertensive crisis.
Question 6: What is the purpose of conducting a medication reconciliation on patient admission?
- To accurately compare current medications and prevent omissions, duplications, or harmful interactions (Correct answer)
- To generate a billing statement
- To reduce the number of prescribed medications
- To educate the patient about diet
Correct answer: To accurately compare current medications and prevent omissions, duplications, or harmful interactions
Medication reconciliation ensures a complete and accurate medication list at care transitions, preventing discrepancies that can lead to patient harm.
DHA Nursing Pharmacology & Drug Administration 2
A patient on heparin infusion has an aPTT of 200 seconds (therapeutic range 60–100 seconds).
What is the priority nursing action?