Nokea
A nurse is teaching a client who has schizophrenia strategies to cope with anticholinergic effects of Fluphenazine. Which of the following should the nurse suggest to the client to minimize anticholinergic effects?
- A. Take the medication in the morning to prevent insomnia.
- B. Chew sugarless gum to moisten the mouth.
- C. Use cooling measures to decrease fever.
- D. Take an antacid to relieve nausea
Correct Answer: B
Rationale: Chewing gum relieves dry mouth, a common anticholinergic effect of fluphenazine.
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Commercials on TV for erectile dysfunction (ED) medications warn about mixing them with nitrates. Why?
- A. Increased risk of priapism
- B. Profound hypotension
- C. Development of blue discoloration to the visual field
- D. Inactivation of the ED medication effect
Correct Answer: B
Rationale: ED drugs (PDE5 inhibitors) with nitrates cause severe vasodilation, leading to hypotension.
Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. A nurse reviews the client's medical record and would question the prescription if which of the following is noted in the client's history?
- A. Neuralgia
- B. Insomnia
- C. Use of nitroglycerin
- D. Use of multivitamins
Correct Answer: C
Rationale: Sildenafil (Viagra) enhances the vasodilating effect of nitric oxide in the corpus cavernosum of the penis, thus sustaining an erection. Because of the effect of the medication, it is contraindicated with concurrent use of organic nitrates and nitroglycerin. Sildenafil is not contraindicated with the use of vitamins. Neuralgia and insomnia are side effects of the medication.
Vitamin B2 (riboflavin) may be prescribed to:
- A. Decrease the incidence of beriberi
- B. Reduce headaches and migraines
- C. Prevent pernicious anemia
- D. Treat hyperlipidemia
Correct Answer: B
Rationale: Riboflavin has been used to reduce migraine frequency, though evidence is limited.
Prescribing less-expensive generic drugs or drugs off the 4 retail pharmacy lists:
- A. Increases the complexity of the pharmacoeconomics of prescribing for the individual patient
- B. Increases compliance by reducing the financial burden of drug costs to the patient
- C. Is not sound prescribing practice due to the inferiority of the generic products
- D. Will increase the overall cost of drugs to the system due to the ease of overprescribing less-expensive drugs
Correct Answer: B
Rationale: Generic drugs improve adherence by lowering patient costs.
A physician has ordered intramuscular (IM) injections of morphine, a narcotic, every 4 hours as needed for pain in a motor vehicle accident victim. The nurse is aware this drug has a high abuse potential. Under what category would morphine be classified?
- A. Schedule I
- B. Schedule II
- C. Schedule III
- D. Schedule IV
Correct Answer: B
Rationale: Narcotics with a high abuse potential are classified as Schedule II drugs because of severe dependence liability. Schedule I drugs have high abuse potential and no accepted medical use. Schedule III drugs have a lesser abuse potential than II and an accepted medical use. Schedule IV drugs have low abuse potential and limited dependence liability.