Nokea
A nurse is teaching an adolescent client who has a new prescription for Clomipramine for OCD. Which of the following instructions should the nurse include to minimize an adverse effect of his medication?
- A. Wear sunglasses when outdoors.
- B. Check your temperature daily.
- C. Take this medication in the morning.
- D. Add extra calories to your die
Correct Answer: A
Rationale: Clomipramine can cause photosensitivity; sunglasses minimize this adverse effect.
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What needs to happen to the protein-drug complex for the drugs to reach the cells where the drug can act?
- A. The protein-drug complex must break itself into smaller pieces to enter the capillaries.
- B. The binding site on the protein picks up a chemical to make it soluble in the serum.
- C. The drug must break away from the protein-binding site and float freely.
- D. The drug must be dissolved in the plasma so it can enter the capillaries and then the tissues.
Correct Answer: C
Rationale: Most drugs are bound, to some extent, to proteins in the blood to be carried into circulation. The protein-drug complex is relatively large and cannot enter into capillaries and then into tissues to react. The drug must be freed from the protein's binding site at the tissues. This occurs without the introduction of another chemical or by dissolving in it plasma.
Which of the following adverse effects of chronic high-dose prednisone administration represents a mineralocorticoid effect?
- A. Buffalo hump
- B. Easy bruising
- C. Edema
- D. Moon facies
Correct Answer: C
Rationale: Edema is a mineralocorticoid effect of prednisone due to sodium and water retention.
The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most effective when applied:
- A. Immediately before swimming
- B. 15 minutes before exposure to the sun
- C. Immediately before exposure to the sun
- D. At least 30 minutes before exposure to the sun
Correct Answer: D
Rationale: Sunscreens are most effective when applied at least 30 minutes before exposure to the sun so that they can penetrate the skin. All sunscreens should be reapplied after swimming or sweating.
Which of the following is the most frequent cause of weight loss and decrease of apetite:
- A. While using insulin medications
- B. While treated with acarbose
- C. While treated with metformin
- D. While treated with glibenclamid
Correct Answer: C
Rationale: Metformin often causes weight loss and reduced appetite as a side effect due to its effects on metabolism and gastrointestinal function.
If the measles, mumps, rubella, and varicella (MMRV) combined vaccine is ordered to be given as the first MMR and varicella dose to a child the CDC recommends:
- A. Parents be informed of the increased risk of fever and febrile seizures over the MMR plus varicella two-shot regimen
- B. Patients must also receive MMRV as the second dose of MMR and varicella in order to build adequate immunity
- C. Patients be premedicated with acetaminophen 15 minutes before the vaccine is given
- D. Patients should not be around pregnant women for the first 48 hours after the vaccine is given
Correct Answer: A
Rationale: MMRV has higher fever/seizure risk vs. separate shots, per CDC; second dose isn't mandated as MMRV.