Nokea
A client has just been prescribed with methotrexate (Trexall) for the treatment of rheumatoid arthritis who did not respond to any other treatment. An important reminder for the client is to?
- A. Clay-colored stool is a normal response to the treatment.
- B. Pregnancy is not contraindicated with the use of the medication.
- C. Strict hand washing.
- D. Get a daily source of sunlight during the day.
Correct Answer: C
Rationale: Methotrexate is an immunosuppressant, increasing the risk of infections. Strict hand washing and infection prevention measures are crucial. Clay-colored stools are not normal and may indicate liver dysfunction. Pregnancy is contraindicated due to the risk of fetal harm. Sunlight exposure should be limited to reduce the risk of photosensitivity reactions.
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Depression that occurs during cold winter months would be classified as
- A. baby blues
- B. bipolar disorder
- C. seasonal affective disorder
- D. obsessive-compulsive disorder
Correct Answer: C
Rationale: Seasonal affective disorder (SAD) ties depression to winter-less light, per psychiatry-unlike baby blues (postpartum), bipolar (cycles), or OCD (obsessions). SAD's seasonal link defines it, matching symptoms.
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.
Which of the following agents exerts its therapeutic effect in multiple sclerosis via potassium channel blockade?
- A. Dalfampridine
- B. Donepezil
- C. Riluzole
- D. Bromocriptine
Correct Answer: A
Rationale: Dalfampridine treats MS by blocking potassium channels in demyelinated axons, enhancing nerve conduction and improving walking ability. Exposed potassium channels in MS leak current, impairing signal propagation; dalfampridine's blockade restores function. Donepezil boosts acetylcholine for Alzheimer's. Riluzole reduces glutamate in ALS. Bromocriptine, a dopamine agonist, manages Parkinson's. Dalfampridine's unique potassium channel action directly addresses MS's neurological deficit, supported by clinical evidence, making it the correct agent here.
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:
Which of the following is NOT an opioid or NSAID?
- A. Morphine
- B. Ibuprofen
- C. Hydromorpho
- D. Acetaminoph en
Correct Answer: D
Rationale: Acetaminophen is not an opioid or NSAID. It is a pain reliever and fever reducer, but it works in a different way compared to opioids and NSAIDs. Unlike opioids, acetaminophen does not have the same risk of physical dependence or addiction. And unlike NSAIDs, acetaminophen does not have anti-inflammatory properties. It is often used for mild to moderate pain relief and as a fever reducer. Be cautious when taking acetaminophen, as high doses can be harmful to the liver.