Nokea
Beta blockers are prescribed for diabetics with caution because of their ability to produce hypoglycemia and block the common symptoms of it. Which of the following symptoms of hypoglycemia is not blocked by these drugs and so can be used to warn diabetics of possible decreased blood glucose?
- A. Dizziness
- B. Increased heart rate
- C. Nervousness and shakiness
- D. Diaphoresis
Correct Answer: D
Rationale: Diaphoresis (sweating) is not blocked by beta blockers and signals hypoglycemia.
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Dwayne has recently started on carbamazepine to treat seizures. He comes to see you and you note that while his carbamazepine levels had been in the therapeutic range, they are now low. The possible cause for the low carbamazepine levels include:
- A. Dwayne hasn't been taking his carbamazepine because it causes insomnia.
- B. Carbamazepine auto-induces metabolism, leading to lower levels in spite of good compliance.
- C. Dwayne was not originally prescribed the correct amount of carbamazepine.
- D. Carbamazepine is probably not the right antiseizure medication for Dwayne.
Correct Answer: B
Rationale: Carbamazepine induces its own metabolism (auto-induction), reducing levels over time.
Which action will the nurse take when it is determined that the narcotic count is incorrect while obtaining a medication from the narcotic area?
- A. Determine the cause of the discrepancy at the end of the shift.
- B. Notify the health care provider stat.
- C. Call the nurse from the previous shift to determine if there was a discrepancy earlier.
- D. Report the discrepancy to the charge nurse immediately.
Correct Answer: D
Rationale: Reporting the discrepancy to the charge nurse immediately enables the supervisory staff to narrow the time frame during which a medication was taken and not documented. The discrepancy needs to be addressed immediately, and therefore determining the cause of the discrepancy at the end of the shift is not the most appropriate action for the nurse to take. It is not appropriate to contact the health care provider for an incorrect narcotic count. The count would have been verified at shift change; calling the nurse from the previous shift is not an appropriate action for the nurse to take.
A nurse is assessing a pregnant client and learns that the client is addicted to cocaine. The nurse informs the client about the risks of cocaine addiction for her fetus. Which of the following would the nurse include?
- A. The child may be born with diabetes.
- B. The child may be born with hypertension.
- C. The child may be born with an addiction to drugs.
- D. The child may be born with CNS defects.
Correct Answer: C
Rationale: The nurse informs the client that children born to mothers using addictive drugs are often born with an addiction to the drug. Children born to mothers who are addicted to cocaine are not known to be born with diabetes, CNS defects, or hypertension.
The following class of drugs may be used to treat Parkinsonian syndrome arising from the use of phenothiazines:
- A. Nicotinic receptor antagonists
- B. Muscarinic receptor antagonists
- C. Adrenoceptor antagonists
- D. Anticholinesterases
Correct Answer: B
Rationale: Antimuscarinics (e.g., benztropine) relieve parkinsonism from phenothiazines.
You need to infuse 1,200 mL of a medication over 6 hours with a drop factor of 10 gtt/mL. Calculate the flow rate in drops per minute.
- A. 30 gtt/min
- B. 33 gtt/min
- C. 40 gtt/min
- D. 50 gtt/min
Correct Answer: B
Rationale: Flow rate = (1,200 mL 10 gtt/mL) ÷ (6 60) = 12,000 ÷ 360 = 33.33 gtt/min, rounded to 33 gtt/min (same as Q4).