Nokea
A nurse is providing teaching to a client who has a new prescription for Amitriptyline for treatment of depression. Which of the following should the nurse include in the teaching?
- A. Expect therapeutic effects in 24 to 48 hr.
- B. Discontinue the medication after a week of improved mood.
- C. Change positions slowly to minimize dizziness.
- D. Decrease injury from the first dose.
Correct Answer: C
Rationale: Slow position changes prevent dizziness, and chewing gum relieves dry mouth, common with tricyclics like amitriptyline.
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A thorough understanding of herbs is critical to patient safety. An example is the use of cinnamon to treat type II diabetes. It is important the patient uses Ceylon cinnamon, as the commercially available cassia cinnamon contains:
- A. Coumadin, which may lead to bleeding problems
- B. Coumarin, which can cause liver and kidney damage
- C. Cinnamic aldehyde, which is toxic to the kidney
- D. Cinnamate eugenol, which is toxic to the liver
Correct Answer: B
Rationale: Cassia cinnamon contains coumarin, which can be hepatotoxic and nephrotoxic in high doses.
The following drug may be used in the management of acromegaly:
- A. Leuprolide
- B. Octreotide
- C. Cosyntropin
- D. Desmopressin
Correct Answer: B
Rationale: Octreotide, a somatostatin analog, inhibits growth hormone in acromegaly.
A 7-year-old boy fell off a wood pile while playing. He has been admitted to the intensive care unit with multiple broken bones and internal bleeding. What should the nurse know about drug therapy in this type of patient?
- A. Adverse effects may be decreased.
- B. Therapeutic effects may be increased.
- C. Pharmacodynamics may be altered.
- D. Pharmacokinetics remain the same
Correct Answer: C
Rationale: Trauma alters pharmacodynamics (drug effects), requiring careful monitoring.
Choose an antihypertensive agent that is most likely to produce tachycardia, fluid retention and hirsutism?
- A. Captopril
- B. Guanethidine
- C. Minoxidil
- D. Prazosin
Correct Answer: C
Rationale: Minoxidil causes reflex tachycardia, fluid retention, and hirsutism.
Which diuretic is classified as a thiazide?
- A. Furosemide
- B. Spironolactone
- C. Hydrochlorothiazide
- D. Mannitol
Correct Answer: C
Rationale: Hydrochlorothiazide is a thiazide diuretic, acting on the distal convoluted tubule, unlike furosemide (loop), spironolactone (potassium-sparing), or mannitol (osmotic).