Nokea
Patients with pheochromocytoma should avoid which of the following classes of drugs because of the possibility of developing hypertensive crisis?
- A. Expectorants
- B. Beta-2-agonists
- C. Antitussives
- D. Antihistamines
Correct Answer: B
Rationale: Beta-2-agonists can stimulate catecholamine release in pheochromocytoma, risking hypertensive crisis; other classes are safer.
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While receiving treatment for acute pulmonary edema, a woman complains of tinnitus and vertigo.
- A. Clomiphene
- B. Hydrochlorothiazide
- C. Furosemide
- D. Mifepristone
Correct Answer: C
Rationale: Furosemide, a loop diuretic, can cause ototoxicity (tinnitus, vertigo) at high doses.
What is medication reconciliation?
- A. Comparing the patient's current medication orders to all of the medications actually being taken
- B. The administration of high alert medications that have been ordered on admission to an acute care facility
- C. The completion of an incident report following a variance that resulted in a serious complication
- D. A printout of computerized patient data that identifies the times that all of the ordered medications are to be administered
Correct Answer: A
Rationale: Medication reconciliation is the process of comparing a patient's current medication orders to all of the medications that the patient is actually taking. Administering high alert medications and completing an incident report are not the same as medication reconciliation. A printout of computerized patient data that identifies the times that all of the ordered medications are to be administered is a description of the medication administration record (MAR), not a description of medication reconciliation.
Which of the following drugs interacts with nitroglycerine by inhibiting the metabolism of cGMP?
- A. Amyl nitrite
- B. Sildenafil
- C. Isosorbide mononitrate
- D. Nifedipine
Correct Answer: B
Rationale: Sildenafil, a PDE5 inhibitor, increases cGMP, enhancing nitroglycerin's hypotensive effect.
A client newly diagnosed with diabetes tells the nurse, 'I can't take any insulin made from pigs or cows.' Which of the following responses by the nurse is best?
- A. Most insulin comes from animal sources, but I'm sure alternative options are available.'
- B. Medications that are derived from animals are typically less expensive than synthetic medications, but synthetic insulin is commonly available.'
- C. Most insulin is synthetic now to help reduce the risk of disease transmission.'
- D. The animals aren't hurt in the production of medications, so you don't need to worry.'
Correct Answer: C
Rationale: Most insulin today is synthetic (e.g., recombinant DNA technology), reducing disease transmission risks and addressing patient concerns about animal sources effectively.
A nurse is providing teaching for a client who has a new prescription for Metformin. Which of the following adverse effects of Metformin should be correct the client to report to the provider?
- A. Somnolence
- B. Constipation
- C. Fluid retention
- D. Weight gain
Correct Answer: A
Rationale: Somnolence could indicate lactic acidosis, a rare but serious metformin side effect to report.