Nokea
A patient with extremely high blood pressure (BP) is in the emergency department. The physician will order therapy with nitroglycerin to manage the patient™s BP. Which form of nitroglycerin is most appropriate?
- A. Sublingual spray
- B. Transdermal patch
- C. Oral capsule
- D. IV infusion
Correct Answer: D
Rationale: In the emergency management of a patient with extremely high blood pressure, intravenous (IV) administration of nitroglycerin is the most appropriate form of delivery. IV infusion provides rapid and precise control of blood pressure by allowing the medication to take effect quickly and be titrated to the desired blood pressure level. This route of administration is crucial in acute settings like the emergency department, where immediate blood pressure management is needed. Other forms of nitroglycerin, such as sublingual spray, transdermal patch, or oral capsule, may not provide the rapid onset of action required in this critical situation.
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A patient asks how to apply transdermal nitroglycerin. What is the nurse™s best response?
- A. Always apply the transdermal patch over the area of your chest where your heart is.
- B. Keep the previous patch on for 1 full day so you always have two patches on at a tim
- C.
- D. Apply the patch to hairless areas of the body.
Correct Answer: D
Rationale: Transdermal nitroglycerin patches should be applied to clean, dry, hairless areas of the body to ensure proper absorption of the medication. Hair can interfere with the absorption of the medication through the skin. Commonly recommended areas for application include the chest, upper arm, or abdomen. It is important to rotate application sites to prevent skin irritation and to follow the specific instructions provided by the healthcare provider or pharmacist.
Morphine over dose is treated with_____
- A. Naloxone
- B. Vitamin K
- C. Time
- D. Grapefruit juice
Correct Answer: A
Rationale: Morphine overdose is a medical emergency that can result in respiratory depression and potentially lead to death. Naloxone is a medication used to counteract the effects of opioids like morphine by binding to the same receptors in the brain and reversing the respiratory depression. Naloxone works quickly to restore normal breathing and consciousness in individuals who have overdosed on morphine. It is a critical intervention used to prevent fatal outcomes of opioid overdose, including morphine. Other options like Vitamin K, time, and grapefruit juice are not effective treatments for morphine overdose.
A 48-year-old woman pricks her finger on a rose bush while pruning. A few days later, she develops small, red lesions near the wound and a red track ascending her hand toward her trunk. Her doctor prescribes itraconazole for the sporotrichosis. What is the mechanism of action of this medication?
- A. Disrupts fungal cell membrane by forming pores (nystatin, amphotericin B)
- B. Disrupts fungal microtubules (griseofulvin)
- C. Inhibits conversion of lanosterol to ergosterol
- D. Inhibits squalene monooxygenase (terbinafine)
Correct Answer: C
Rationale: Sporotrichosis, from Sporothrix schenckii, requires antifungals like itraconazole. Option , inhibiting lanosterol to ergosterol conversion, is correct-itraconazole blocks 14-α-demethylase, disrupting fungal membrane synthesis. Option , pore formation, is amphotericin B's mechanism. Option , microtubule disruption, is griseofulvin's. Option , squalene monooxygenase inhibition, is terbinafine's. Option (E), 5-FU conversion, is flucytosine's. Itraconazole's ergosterol inhibition effectively treats this subcutaneous infection, targeting fungal viability.
Enteric coated acetylsalicylic acid has been prescribed for a patient to treat chronic arthritis. The patient calls the clinic nurse because of gagging and difficulty swallowing the tablets. What response would the nurse give to the patient?
- A. Crush the tablets and mix with juice or food'
- B. I’ll notify the healthcare provider for a medication change'
- C. Open the tablet and mix the contents with food'
- D. Swallow the tablets with large amounts of water or milk'
Correct Answer: D
Rationale: Enteric-coated tablets should not be crushed or opened, as this disrupts their protective coating and can cause gastric irritation. The patient should be instructed to swallow the tablets whole with plenty of water or milk. Crushing (A) or opening the tablets (C) is inappropriate. Notifying the healthcare provider (B) may be necessary if the patient cannot tolerate the medication.
If you inject a drug with a pH of 6.5 and pka of 8.1 into a tissue with a pH of 7.4, to what extent would you expect this drug to be ionized in the tissue?
- A. over 50%
- B. 50%
- C. under 50%
- D. 100%
Correct Answer: A
Rationale: The percentage of ionization of a weak acid or base can be estimated using the Henderson-Hasselbalch equation: