Nokea
A nurse is assessing a client who has taken Procainamide to treat dysrhythmias for the last 12 months. The nurse should assess the client for which of the following adverse effects of this medication? (Select one that does not apply.)
- A. Joint swelling
- B. Widened QRS complex
- C. Narrowed QT interval
- D. Easy bruising
Correct Answer: C
Rationale: Procainamide can widen QRS , cause bruising from lupus-like syndrome, and joint swelling .
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The client has a PRN prescription for ondansetron (Zofran). For which condition should this medication be administered to the postoperative client?
- A. Paralytic ileus
- B. Incisional pain
- C. Urinary retention
- D. Nausea and vomiting
Correct Answer: D
Rationale: Ondansetron is an antiemetic used to treat postoperative nausea and vomiting, as well as nausea and vomiting associated with chemotherapy. The other options are incorrect.
A patient with anxiety and depression may respond to:
- A. Duloxetine (Cymbalta)
- B. Fluoxetine (Prozac)
- C. Oxazepam (Serax)
- D. Buspirone (Buspar) and an SSRI combined
Correct Answer: D
Rationale: Buspirone (anxiolytic) with an SSRI addresses both anxiety and depression effectively.
A nurse is caring for a patient who has been receiving a drug by the intramuscular route but will receive the drug orally after discharge. How does the nurse explain the increased dosage prescribed for the oral dose?
- A. Passive diffusion
- B. Active transport
- C. Glomerular filtration
- D. First-pass effect
Correct Answer: D
Rationale: The first-pass effect involves drugs that are absorbed from the small intestine directly into the portal venous system, which delivers the drug molecules to the liver. After reaching the liver, enzymes break the drug into metabolites, which may become active or may be deactivated and readily excreted from the body. A large percentage of the oral dose is usually destroyed and never reaches tissues. Oral dosages account for the phenomenon to ensure an appropriate amount of the drug in the body to produce a therapeutic action. Passive diffusion is the major process through which drugs are absorbed into the body. Active transport is a process that uses energy to actively move a molecule across a cell membrane and is often involved in drug excretion in the kidney. Glomerular filtration is the passage of water and water-soluble components from the plasma into the renal tubule.
A patient requires 1,000 mL of IV fluid to be infused over 10 hours with a drop factor of 20 gtt/mL. What is the flow rate in drops per minute?
- A. 33 gtt/min
- B. 50 gtt/min
- C. 67 gtt/min
- D. 100 gtt/min
Correct Answer: A
Rationale: Flow rate = (Volume Drop factor) ÷ Time in minutes = (1,000 mL 20 gtt/mL) ÷ (10 60) = 20,000 ÷ 600 = 33.33 gtt/min, rounded to 33 gtt/min.
Which of the following drugs has been shown to restore corticosteroid responsiveness for Bronchial Asthma:
- A. Salbutamol
- B. Sodium cromoglycate
- C. Zifirlukast
- D. Montelukast
Correct Answer: D
Rationale: Montelukast, a leukotriene inhibitor, enhances corticosteroid efficacy in asthma.