Nokea
Kelly has diarrhea and is wondering if she can take loperamide (Imodium) for the diarrhea. Loperamide:
- A. Can be given to patients of all ages, including infants and children, for viral gastroenteritis
- B. Slows gastric motility and reduces fluid and electrolyte loss from diarrhea
- C. Is the treatment of choice for the diarrhea associated with E. coli 0157
- D. May be used in pregnancy and by lactating women
Correct Answer: B
Rationale: Loperamide slows motility to reduce diarrhea; it's not for infants , E. coli 0157 (C, risks toxicity), or universally safe in pregnancy .
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A nurse is caring for a client after thyroidectomy and notes that calcium gluconate is prescribed for the client. The nurse determines that this medication has been prescribed to:
- A. Treat thyroid storm.
- B. Prevent cardiac irritability.
- C. Treat hypocalcemic tetany.
- D. Stimulate the release of parathyroid hormone.
Correct Answer: C
Rationale: Hypocalcemia can develop after thyroidectomy if the parathyroid glands are accidentally removed or injured during surgery. Manifestations develop 1 to 7 days after surgery. If the client develops numbness and tingling around the mouth, fingertips, or toes or muscle spasms or twitching, the health care provider is notified immediately. Calcium gluconate should be kept at the bedside.
A patient is prescribed lidocaine for ventricular arrhythmias. Which side effect should the nurse monitor for?
- A. Hypotension
- B. Nausea
- C. Seizures
- D. Bradycardia
Correct Answer: C
Rationale: Lidocaine, a Class IB antiarrhythmic, can cause CNS side effects like seizures at high doses, a key monitoring point.
What does the nurse understand must occur in order to produce withdrawal syndrome?
- A. Addiction
- B. Craving
- C. Drug tolerance
- D. Physical dependence
Correct Answer: D
Rationale: Physical dependence causes withdrawal when a drug stops; addiction or tolerance don't suffice. Patients who develop a physical dependence on a drug will experience withdrawal syndrome when the drug is stopped.
Drugs which increase GABA levels in brain
- A. Diazepam
- B. Phenobarbitone
- C. Sodium valproate
- D. Carbamazepine
Correct Answer: C
Rationale: Sodium valproate increases GABA levels.
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.