Nokea
A nurse is providing instructions to a client who has a new prescription for Albuterol and Beclomethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching?
- A. Take the albuterol at the same time each day.
- B. Administer the albuterol inhaler prior to using the beclomethasone inhaler.
- C. Use beclomethasone if experiencing an acute episode.
- D. Avoid shaking the beclomethasone before us
Correct Answer: B
Rationale: Albuterol (bronchodilator) should be used before beclomethasone (steroid) to open airways for better steroid delivery.
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Which of the following drugs is used for the management of atropine intoxication?
- A. Physostigmine
- B. Neostigmine
- C. Endrophonium
- D. Donepezil
Correct Answer: A
Rationale: Physostigmine, a cholinesterase inhibitor, crosses the BBB to reverse atropine's central effects.
Henry is 82 years old and takes two aspirin every morning to treat the arthritis pain in his back. He states the aspirin helps him to 'get going' each day. Lately he has had some heartburn from the aspirin. After ruling out an acute GI bleed, what would be an appropriate course of treatment for Henry?
- A. Add an H2 blocker such as ranitidine to his therapy
- B. Discontinue the aspirin and switch him to Vicodin for the pain
- C. Decrease the aspirin dose to one tablet daily
- D. Have Henry take an antacid 15 minutes before taking the aspirin each day
Correct Answer: A
Rationale: An H2 blocker reduces aspirin-induced heartburn; stopping or antacids don't address chronic use.
A patient with an edema would have an increased volume of distribution (Vd) if?
- A. The patient was taking an anionic drug
- B. The patient was taking a hydrophobic drug
- C. The patient was taking a hydrophilic drug
- D. An edema always causes an increase in Vd
Correct Answer: C
Rationale: Edema increases extracellular fluid, raising Vd for hydrophilic drugs that distribute into this compartment, not hydrophobic drugs (tissue-bound) or universally.
Following are the sign and symptoms of acute morphine poisoning EXCEPT
- A. Respiratory depression with shallow breathing
- B. Hyperthermia
- C. Pin-point pupil
- D. Hypotension
Correct Answer: B
Rationale: Acute morphine poisoning typically causes respiratory depression, miosis (pin-point pupils), and hypotension, but hypothermia, not hyperthermia, is common due to opioid-induced CNS depression.
An important concept taught by the nurse when providing medication teaching is the need to provide a complete list of medications taken to health care providers to avoid what?
- A. Spending large amounts of money on medications
- B. Allergic reactions to medications
- C. Drug-drug interactions
- D. Critical concentrations of medications in the body
Correct Answer: C
Rationale: It is important that all health care providers have a complete list of the patients medications to avoid drug-drug interactions caused by one provider ordering a medication, unaware of another medication the patient is taking that could interact with the new prescription. Using the same pharmacist for all prescriptions will also help to prevent this from happening. Informing the provider of all medications taken will not reduce costs of medications, which is best accomplished by requesting generic medications. Allergies should be disclosed to all health care providers as well, but this is not why it is important to provide a complete list of medications taken. Critical concentrations are desirable because that is the amount of drug needed to cause a therapeutic effect, or, in other words, to have the effect the drug is prescribed for.