Nokea
A client has a new prescription for Hydralazine. Which of the following side effects should the nurse instruct the client to monitor for and report?
- A. Orthostatic hypotension
- B. Increased heart rate
- C. Dark-colored urine
- D. Persistent cough
Correct Answer: B
Rationale: Corrected Rationale: Hydralazine, a vasodilator, can cause reflex tachycardia, leading to an increased heart rate. This side effect should be reported to the healthcare provider to ensure appropriate management and monitoring of the client's condition. Choice A (Orthostatic hypotension) is incorrect as Hydralazine is more likely to cause reflex tachycardia than orthostatic hypotension. Choice C (Dark-colored urine) and Choice D (Persistent cough) are unrelated to the common side effects of Hydralazine and should not be the focus of monitoring for this medication.
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Which adverse reaction poses the greatest life-threatening risk when taking Omeprazole?
- A. Chest pain
- B. Constipation
- C. Clostridium difficile-associated diarrhea
- D. Acute interstitial nephritis
Correct Answer: C
Rationale: The most life-threatening adverse reaction associated with Omeprazole is Clostridium difficile-associated diarrhea. This condition can be severe and life-threatening due to the potential for dehydration, electrolyte imbalances, and complications such as toxic megacolon. Chest pain, constipation, and acute interstitial nephritis are potential side effects of Omeprazole but are not considered as life-threatening as Clostridium difficile-associated diarrhea. Monitoring for signs of this adverse reaction is crucial, and immediate medical attention should be sought if symptoms develop.
Which one of the following antipsychotics has been shown to be a partial agonist at the dopamine D2 receptor?
- A. Aripiprazole
- B. Clozapine
- C. Haloperidol
- D. Risperidone
Correct Answer: A
Rationale: Aripiprazole, a third-generation antipsychotic, acts as a partial agonist at D2 receptors, stabilizing dopamine activity: it activates receptors in low-dopamine states (e.g., negative symptoms) and competes with excess dopamine (e.g., psychosis), reducing side effects like EPS. Clozapine, a second-generation drug, has weak D2 affinity, targeting 5HT2 and other receptors. Haloperidol, a first-generation antipsychotic, is a D2 antagonist. Risperidone and thioridazine block D2 fully, not partially. Aripiprazole's unique partial agonism, confirmed by pharmacological data, balances efficacy and tolerability, distinguishing it in schizophrenia treatment.
A patient was admitted to the emergency department with a pulse oximeter reading of 85% after a successful prehospital resuscitation from cardiac arrest due to an asthma attack. What is the most important initial drug to administer as ordered?
- A. Epinephrine
- B. Sodium bicarbonate
- C. Albuterol
- D. Oxygen
Correct Answer: D
Rationale: Oxygen is the most important initial intervention for a patient with a low pulse oximeter reading (85%) to correct hypoxia and prevent further complications. While epinephrine (A) and albuterol (C) are used to treat asthma, oxygen is the priority to address the immediate hypoxia. Sodium bicarbonate (B) is not indicated unless there is severe metabolic acidosis.
Recent studies into the pathogenesis of halothane-induced malignant hyperthermia indicate which of the following as the likely implicating cause?
- A. Drug toxicity
- B. Excitation-contraction coupling defect
- C. Myoplasmic sodium defect
- D. Oxygen-hemoglobin concentration deficit
Correct Answer: B
Rationale: Malignant hyperthermia (MH) from halothane involves excitation-contraction coupling defects . MH, a genetic disorder, stems from ryanodine receptor (RYR1) mutations, causing uncontrolled calcium release in muscle, not drug toxicity . Sodium defects , oxygen deficits , or neural overmodulation (E) aren't implicated. This coupling defect triggers hypermetabolism, explaining MH's rapid onset with halothane exposure.
When educating a patient about Regular Insulin, you should include which instruction:
- A. Shake the vial vigorously
- B. Expect the solution to appear cloudy
- C. Store unopened vials at room temperature
- D. Inject the insulin subcutaneously
Correct Answer: D
Rationale: When educating a patient about Regular Insulin, you should include the instruction to inject the insulin subcutaneously. Regular insulin is a short-acting insulin that should be injected into the subcutaneous tissue rather than intramuscularly or intravenously. Subcutaneous injection ensures proper absorption and effectiveness of the insulin. It is important to educate the patient on the correct injection technique and site rotation to optimize insulin absorption and minimize the risk of lipodystrophy.