Nokea
A 19-year-old male was started on risperidone. Monitoring for risperidone includes observing for common side effects, including:
- A. Bradykinesia, akathisia, and agitation
- B. Excessive weight gain
- C. Hypertension
- D. Potentially fatal agranulocytosis
Correct Answer: A
Rationale: Risperidone frequently causes movement disorders like bradykinesia and akathisia.
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You are managing the care of a patient recently diagnosed with benign prostatic hyperplasia (BPH). He is taking tamsulosin but reports dizziness when standing abruptly. The best option for this patient is:
- A. Continue the tamsulosin because the side effect will resolve with continued treatment.
- B. Discontinue the tamsulosin and start doxazosin.
- C. Have him double his fluid intake and stand more slowly.
- D. Prescribe meclizine as needed for the dizziness.
Correct Answer: C
Rationale: Orthostatic hypotension from tamsulosin is managed by rising slowly and ensuring hydration.
A patient who is taking isoniazid (INH) as part of a two-drug tuberculosis treatment regimen reports tingling of the fingers and toes. The nurse will recommend discussing which treatment with the provider?
- A. Adding pyrazinamide
- B. Changing to ethambutol
- C. Increasing oral fluid intake
- D. Taking pyridoxine (B6)
Correct Answer: D
Rationale: Pyridoxine prevents INH-induced neuropathy (tingling); changing drugs or fluids doesn't address this. Peripheral neuropathy is an adverse reaction to INH, so pyridoxine is usually given to prevent this.
Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When applying the medication, the client complains of local discomfort and burning. Which of the following is the most appropriate nursing action?
- A. Notifying the registered nurse
- B. Discontinuing the medication
- C. Informing the client that this is normal
- D. Applying a thinner film than prescribed to the burn site
Correct Answer: C
Rationale: Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms and is used to treat burns to reduce bacteria present in avascular tissues. The client should be informed that the medication will cause local discomfort and burning and that this is a normal reaction; therefore options 1, 2, and 4 are incorrect.
A nurse is preparing a drug for administration to a patient. The drug does not have an indicated use for the patient's medical diagnosis. What should the nurse do?
- A. Administer the drug as ordered.
- B. Question the prescriber concerning the ordered drug.
- C. Ask a coworker his or her thoughts about the ordered drug for the patient.
- D. Ask the patient why the drug has been prescribed for him or her.
Correct Answer: B
Rationale: If the nurse is not sure about giving a drug, the order should be questioned. The nurse should never give a medication that is not clear. Mistakes do happen and the drug ordered, if not approved for the condition that the patient has, could be an error on someone's part. The person who wrote the order should be questioned, not a co worker, who probably does not know why an off-label drug is being used. It would be unprofessional and inappropriate to ask the patient about the drug.
Clonidine has several off-label uses, including:
- A. Alcohol and nicotine withdrawal
- B. Post-herpetic neuralgia
- C. Both 1 and 2
- D. Neither 1 nor 2
Correct Answer: C
Rationale: Clonidine is used off-label for both alcohol/nicotine withdrawal and post-herpetic neuralgia.