Nokea
A nurse in an acute care facility is caring for a client who is receiving IV Nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication?
- A. Intestinal ileus
- B. Neutropenia
- C. Deurium
- D. Hyperthermia
Correct Answer: C
Rationale: Nitroprusside can cause delirium (C, likely typo for delirium), a CNS side effect in toxicity.
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A nurse is instructing a pregnant patient concerning the potential risk to her fetus from a pregnancy category B drug. The nurse would inform the patient that:
- A. Adequate studies in pregnant women have demonstrated there is no risk to the fetus.'
- B. Animal studies have not demonstrated a risk to the fetus but there have been no adequate studies in pregnant women.'
- C. Animal studies have shown an adverse effect on the fetus but there are no adequate studies in pregnant women.'
- D. There is evidence of human fetal risk but the potential benefits from use of the drug may be acceptable despite potential risks.'
Correct Answer: B
Rationale: Category B indicates that animal studies have not demonstrated a risk to the fetus but there have been no adequate studies in pregnant women. However, there have not been adequate studies in pregnant women to demonstrate risk to a fetus during the first trimester of pregnancy and no evidence of risk in later trimesters. Category A indicates that adequate studies in pregnant women have not demonstrated a risk to the fetus in the first trimester or in later trimesters. Category C indicates that animal studies have shown an adverse effect on the fetus but there have been no adequate studies in humans. Category D reveals evidence of human fetal risk, but the potential benefits from the use of the drugs in pregnant women may outweigh the risks.
Potentially fatal granulocytopenia has been associated with treatment of hyperthyroidism with propylthiouracil. Patients should be taught to report:
- A. Tinnitus and decreased salivation
- B. Fever and sore throat
- C. Hypocalcemia and osteoporosis
- D. Laryngeal edema and difficulty swallowing
Correct Answer: B
Rationale: Fever and sore throat signal granulocytopenia with propylthiouracil; other symptoms are unrelated.
A nurse is assisting with caring for a client with cancer who is receiving cisplatin. Select the adverse effects that the nurse monitors for that are associated with this medication. (Select one that does not apply.)
- A. Tinnitus
- B. Ototoxicity
- C. Hyperkalemia
- D. Hypomagnesemia
Correct Answer: C
Rationale: Cisplatin is an alkylating medication. Alkylating medications are cell cycle phase-nonspecific medications that affect the synthesis of DNA by causing the cross-linking of DNA to inhibit cell reproduction. Cisplatin may cause ototoxicity, tinnitus, hypokalemia, hypocalcemia, hypomagnesemia, and nephrotoxicity. Amifostine (Ethyol) may be administered before cisplatin to reduce the potential for renal toxicity. Correct answers include: 1 (Tinnitus), 2 (Ototoxicity), 5 (Nephrotoxicity), 6 (Hypomagnesemia).
Serum level of drug is monitored when the patient is on
- A. Lithium
- B. Haloperidol
- C. Diazepam
- D. Acetazolamide
Correct Answer: A
Rationale: Lithium requires monitoring due to its narrow therapeutic range.
Which of the following drug has the ability to produce hypogliceic effect via closure of ATP-sensitive channels
- A. Glipizide
- B. Metformin
- C. Acarbose
- D. Pramlintide
Correct Answer: A
Rationale: Glipizide, a sulfonylurea, closes ATP-sensitive K+ channels, stimulating insulin release.