Nokea
A nurse is caring for a patient who is taking Digoxin. The nurse should instruct the patient to monitor and report which of the following adverse e昀昀ects? ( select all the apply)
- A. Fatigue
- B. Constipation
- C. Anorexia
- D. Rash
Correct Answer: A
Rationale: A. Fatigue: Digoxin, a medication commonly used to treat heart conditions, can cause side effects such as fatigue. Patients taking Digoxin should monitor and report any unusual fatigue or weakness to their healthcare provider.
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Which of the following medications would you administer for an overdose of acetaminophen?
- A. Naloxone
- B. Vitamin K
- C. Acetylcysteine
- D. Atropine
Correct Answer: C
Rationale: Acetylcysteine is the specific antidote for acetaminophen overdose. Acetaminophen (also known as paracetamol) toxicity can cause severe liver damage if not treated promptly. Acetylcysteine works by replenishing the depleted glutathione stores in the liver, helping to prevent liver damage and improving the patient's outcome. Naloxone is used for opioid overdose, vitamin K for reversing the effects of certain anticoagulants, and atropine for specific heart and nerve related conditions.
An injection of penicillin into a penicillin-sensitized person may lead to death due to:
- A. absence of histamine
- B. a Shwartzman's reaction
- C. release of enzymes from polymorphonuclear leukocytes
- D. constriction of bronchioli and drop in blood pressure
Correct Answer: B
Rationale: A Shwartzman's reaction is a severe inflammatory response that occurs when a person who has previously been sensitized to penicillin is re-exposed to the drug. This exaggerated response can lead to widespread activation of inflammatory mediators and is characterized by endotoxin-induced intravascular coagulation. This can result in a cascade of events leading to tissue damage, organ failure, and potentially death. It is different from a typical allergic reaction mediated by histamine release or constriction of bronchioli and drop in blood pressure. Additionally, the release of enzymes from polymorphonuclear leukocytes is not directly related to the fatal outcome of a penicillin injection in a sensitized individual.
A child was brought to the emergency room complaining of right upper quadrant abdominal pain, nausea, and vomiting. Upon the interview of the nurse to the mother, the client has been taking a long-
- A. Which of the following medications should be readily available?
- B. naltrexone (ReVi
- C. urea (Ureaphil)
- D. acetylcysteine (Mucomyst)
Correct Answer: A
Rationale: The presentation of right upper quadrant abdominal pain, nausea, and vomiting in a child with a history of taking a long-acting formulation of valproic acid (Depakene) is concerning for valproic acid overdose. Valproic acid toxicity can lead to liver damage, which may present with symptoms such as abdominal pain, nausea, and vomiting. In cases of valproic acid overdose, acetylcysteine (Mucomyst) is commonly used as a treatment to help prevent or reduce liver damage by replenishing glutathione stores and acting as a reactive oxygen species scavenger. Therefore, acetylcysteine should be readily available in this scenario to initiate prompt treatment and potentially prevent severe liver injury.
Which drug concentration is appropriate to administer in an order for epinephrine 0.3 mg IM to treat a severe allergic reaction in an adult patient?
- A. 1:10,000
- B. 0.736111111
- C. 0.111111111
- D. 1:10
Correct Answer: B
Rationale: The appropriate concentration for epinephrine 0.3 mg IM in an adult for a severe allergic reaction is 1:1000. This concentration is used for intramuscular administration, while 1:10,000 (A) is used for intravenous administration in cardiac arrest. Concentrations of 1:100 (C) and 1:10 (D) are not standard for this purpose.
For the patient taking acetaminophen, what should the nurse do? (Select all that apply.)
- A. Monitor routine liver enzyme tests.
- B. Encourage the patient to check package labels of over-the-counter drugs to avoid overdosing.
- C. Report side effects immediately, as toxicity can cause severe hepatic damage.
- D. Teach the female patient that oral contraceptives can increase the effect of acetaminophen.
Correct Answer: D
Rationale: Acetaminophen is metabolized in the liver, and excessive doses can lead to hepatotoxicity. Routine monitoring of liver enzymes is essential to detect early signs of liver damage. Patients should also be educated to check the acetaminophen content in over-the-counter medications to avoid accidental overdose. Reporting side effects promptly is crucial, as acetaminophen toxicity can cause severe and potentially fatal liver damage. While oral contraceptives can affect drug metabolism, they do not significantly increase the effects of acetaminophen. Therefore, the correct actions are to monitor liver enzymes, educate about over-the-counter medications, and report side effects.