OSCE Pharmacology and Medication Administration Flashcards
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Read the first 7 OSCE Pharmacology and Medication Administration flashcards as text
A patient is prescribed a statin for hyperlipidemia and develops muscle pain with a CK level 10 times the upper limit of normal. What is the priority action?
Answer: Discontinue the statin immediately
Markedly elevated CK with muscle symptoms indicates statin-induced myopathy or rhabdomyolysis, requiring immediate discontinuation to prevent renal failure.
Which 'five rights' of medication administration is being verified when the nurse checks the patient's armband?
Answer: Right patient
Checking the patient's armband and using two identifiers verifies the right patient, a core component of safe medication administration.
A patient receives 1,000 mg of acetaminophen (paracetamol) every 6 hours. What is the total daily dose, and is it within safe limits for a healthy adult?
Answer: 4,000 mg/day — at the maximum safe limit
Four doses of 1,000 mg equals 4,000 mg/day, which is the maximum recommended daily dose for healthy adults per current guidelines.
Which class of medications requires dose reduction in hepatic impairment due to extensive first-pass metabolism?
Answer: Oral beta-blockers like propranolol
Propranolol undergoes extensive hepatic first-pass metabolism; liver impairment reduces clearance, leading to significantly elevated plasma levels.
A patient on warfarin is started on ciprofloxacin. What monitoring change is required?
Answer: Monitor INR more frequently as it may rise
Ciprofloxacin inhibits CYP1A2 and CYP3A4, reducing warfarin metabolism and increasing anticoagulant effect, requiring more frequent INR monitoring.
When reconstituting a powdered antibiotic for IV administration, what is the most important step after adding the diluent?
Answer: Gently swirl until completely dissolved before checking clarity
After adding diluent, the vial should be gently swirled and inspected for complete dissolution and clarity/absence of particulates before administration.
A patient with severe penicillin allergy requires treatment for syphilis. What is the recommended alternative?
Answer: Doxycycline
Doxycycline is the recommended alternative for non-pregnant patients with penicillin allergy who have early syphilis, though penicillin remains preferred.
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