Nokea
A 52-year-old man undergoes three surgical procedures in a 2-week period involving debridement of a deep skin abscess. Each surgical anesthesia procedure involves the use of halothane. Which of the following pathologic processes is possible as a result of the surgical procedures?
- A. Cholelithiasis
- B. Hepatic necrosis
- C. Nephrolithiasis
- D. Steatorrhea
Correct Answer: B
Rationale: Repeated halothane anesthesia risks hepatic necrosis . Halothane, a halogenated anesthetic, can cause hepatitis or necrosis, especially with multiple exposures, due to toxic metabolites. Cholelithiasis , kidney stones , steatorrhea , and tinnitus (E) aren't linked. Hepatic necrosis, though rare, is a documented risk, particularly in short-interval surgeries, making it the plausible complication here.
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A client is receiving Enoxaparin for the prevention of deep vein thrombosis. Which of the following actions should the nurse take?
- A. Massage the injection site after administration.
- B. Administer the medication intramuscularly.
- C. Administer the medication into the subcutaneous tissue.
- D. Administer the medication into the deltoid muscle.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client in a coronary care unit is being admitted after CPR post cardiac arrest. The client is receiving IV lidocaine at 2 mg/min. When the client asks the nurse why he is receiving that medication, the nurse should explain that it has which of the following actions?
- A. Prevents dysrhythmias
- B. Slows intestinal motility
- C. Dissolves blood clots
- D. Relieves pain
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client is starting a new prescription for furosemide. Which of the following instructions should the nurse include?
- A. Take the medication with food.
- B. Weigh yourself daily.
- C. Take potassium supplements as needed.
- D. Decrease intake of foods high in sodium.
Correct Answer: B
Rationale: When a client is prescribed furosemide, it is important to monitor for fluid loss. Weighing oneself daily helps track changes in weight due to fluid loss, which can indicate the effectiveness of the medication. This monitoring assists in managing fluid balance and adjusting the dosage if necessary to achieve the desired therapeutic effect.
Individuals who are slow acetylators (i.e. have a relatively low activity of hepatic N-acetyltransferase):
- A. Have a prevalence of 15-20 per cent in European caucasians
- B. Are more likely to develop thrombocytopenia, nephrotic syndrome and rash during gold treatment
- C. Are more likely to develop hepatotoxicity following halothane anaesthesia
- D. Are more likely to develop antinuclear antibodies during hydralazine therapy
Correct Answer: D
Rationale: Slow acetylators have reduced hepatic N-acetyltransferase (NAT2) activity, affecting metabolism of drugs like hydralazine, isoniazid, and procainamide. In European Caucasians, prevalence is actually 50-60%, not 15-20%, making that statement inaccurate. Gold treatment side effects like thrombocytopenia or nephrotic syndrome aren't strongly linked to acetylation status, but rather to immune responses, so that's less relevant. Halothane hepatotoxicity relates to immune-mediated reactions or metabolites, not acetylation speed. Hydralazine, metabolized by NAT2, accumulates in slow acetylators, increasing risk of drug-induced lupus with antinuclear antibodies (ANA), a well-documented association. Agranulocytosis with clozapine isn't tied to acetylation but to idiosyncratic reactions. The ANA risk with hydralazine is the most accurate, reflecting its pharmacogenetic implications, critical for personalized dosing and monitoring.
A client has a new prescription for Nevirapine, an NNRTI. Which of the following statements should the nurse include in teaching the client?
- A. Take this medication on an empty stomach.
- B. Take this medication with food to increase absorption.
- C. Avoid alcohol while taking this medication.
- D. Take this medication at the same time every day.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.