Nokea
A nurse in an emergency unit is reviewing the medical record of a client who is being evaluated for angle-closure Glaucoma. Which of the following findings are indicative of this condition?
- A. Insidious onset of painless loss of vision
- B. Gradual reduction in peripheral vision
- C. Severe pain around eyes
- D. Intraocular pressure 12 mm Hg
Correct Answer: C
Rationale: Angle-closure glaucoma presents with severe eye pain and elevated pressure, unlike the normal 12 mm Hg.
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First dose phenomenon is a characteristic side effect on initiation of antihypertensive therapy with
- A. Minoxidil
- B. Clonidine
- C. Metroprolol
- D. Prazosin
Correct Answer: B
Rationale: Clonidine can cause sedation or hypotension after the first dose.
Which drug has a high first pass effect
- A. Amiodarone
- B. Phenytoin
- C. Verapamil
- D. Disopyramide
Correct Answer: C
Rationale: Verapamil undergoes extensive first-pass metabolism in the liver, reducing its bioavailability when taken orally.
A 73-year-old male patient is being discharged home today. The discharge order reads: Take 10 mL of guaifenesin (Robitussin) with plastic measuring caps. How much should the nurse teach the client to take at home?
- A. 1/2 tsp
- B. 1 tsp
- C. 2 tsp
- D. 1 tbsp
Correct Answer: C
Rationale: 10 mL equals 2 teaspoons (1 tsp = 5 mL), the correct household measure for patient teaching.
A competitive antagonist is a substance that:
- A. Interacts receptors and produces submaximal effect
- B. Binds to the same receptor site and progressively inhibits the agonist response
- C. Binds to the nonspecific sites of tissue
- D. Binds to one receptor subtype as an agonist and to another as an antagonist
Correct Answer: B
Rationale: Competitive antagonists compete for the same receptor site, reversibly inhibiting the agonist.
Patients who need to remain alert are taught to avoid which drug due to its antimuscarinic effects?
- A. Levothyroxine
- B. Prilosec
- C. Dulcolax
- D. Diphenhydramine
Correct Answer: D
Rationale: Diphenhydramine's antimuscarinic effects cause sedation, impairing alertness.