A nurse is reviewing a client's health record and notes that the client experiences permanent extrapyramidal effects caused by a previous medication. The nurse should recognize that the medication affected which of the following systems in the client?
- A. Cardiovascular
- B. Immune
- C. Central nervous
- D. Gastrointestinal
Correct Answer: C
Rationale: Extrapyramidal effects are movement disorders caused by medications affecting the central nervous system , like antipsychotics.
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Zoster vaccine (Zostavax) is:
- A. A live varicella zoster vaccine from the same strain used to develop the varicella vaccine
- B. Effective in preventing varicella zoster in patients of all ages
- C. Recommended for patients age 40 to 80 who have had chickenpox
- D. Administered at the same time as other live vaccines, as long as they are given the same day
Correct Answer: A
Rationale: Zostavax is a live vaccine from the varicella strain, for adults 50+ (not all ages, B, or 40-80, C); timing with other vaccines has restrictions.
Which of the following is the most frequent cause of diarrhea and flatulance:
- A. Acarbose
- B. Glibenclamide
- C. Metformin
Correct Answer: A
Rationale: Acarbose inhibits carbohydrate digestion in the gut, leading to increased fermentation by gut bacteria, causing diarrhea and flatulence.
A nurse is caring for a patient taking multiple drugs and is concerned about a possible drug-drug interaction. What is the nurse's first and best means of avoiding this problem?
- A. Consult a drug guide.
- B. Call the pharmacist.
- C. Contact the provider.
- D. Ask another nurse.
Correct Answer: A
Rationale: Whenever two or more drugs are being given together, first consult a drug guide for a listing of clinically significant drug-drug interactions. Sometimes problems can be avoided by staggering the administration of the drugs or adjusting their dosages. Consulting the pharmacist is not wrong, but it would not be the first action to take. The nurse holds responsibility for his or her own practice so asking a health care provider or another nurse is based on the assumption that that professional is knowledgeable about all drug-drug interactions, which is likely not the case.
For the treatment of morphine addiction which of the following drug is substituted?
- A. Tramadol
- B. Methadone
- C. Fluoxetine
- D. Dextromethorphan
Correct Answer: B
Rationale: Methadone, a long-acting opioid agonist, is commonly substituted for morphine in addiction treatment to reduce withdrawal symptoms and cravings.
Which of the following adverse effects are less likely in a beta1-selective blocker?
- A. Dysrhythmias
- B. Impaired insulin release
- C. Reflex orthostatic changes
- D. Decreased triglycerides and cholesterol
Correct Answer: B
Rationale: Beta1-selective blockers (e.g., atenolol) have less impact on insulin release compared to non-selective blockers.
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