Nokea
A patient arrives at the health care clinic and informs the nurse that he has consumed several aspirin tablets for a severe headache over the past 24 hours. The nurse would be alert for which of the following as a harmful effect?
- A. Gastrointestinal bleeding
- B. Breathing difficulties
- C. Visual disturbances
- D. Loss of balance
Correct Answer: A
Rationale: Aspirin is potentially harmful and can cause gastrointestinal bleeding and salicylism. Breathing difficulties, visual disturbances, and loss of balance could be due to an illness or the effects of some other drug.
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Which of the following is CORRECT about aspirin poisoning?
- A. Is rarely seen in cases of chronic use
- B. It does not affect body temperature
- C. It is treated by administration of intravenous sodium bicarbonate
- D. The earliest sign is hypoventilation
Correct Answer: C
Rationale: Sodium bicarbonate enhances aspirin excretion by alkalinizing urine.
The nurse receives an order to administer an unfamiliar medication and obtains a nurse's drug guide published four years earlier. What is the nurse's most prudent action?
- A. Find a more recent reference source.
- B. Use the guide if the drug is listed.
- C. Ask another nurse for drug information.
- D. Verify the information in the guide with the pharmacist.
Correct Answer: A
Rationale: The nurse is responsible for all medications administered and must find a recent reference source to ensure the information learned about the medication is correct and current. Using an older drug guide could be dangerous because it would not contain the most up-to-date information. Asking another nurse or the pharmacist does not guarantee accurate information will be obtained and could harm the patient if the information is wrong.
Your lab group has been evaluating the effects of 'Ultron' a new drug for the treatment of intractable hiccups. When administered over a wide concentration range, three dose response relationships were defined in test subjects. Using facial flushing as an unwanted side effect, what would be the estimated therapeutic index for Ultron?
- A. 0.1
- B. 100
- C. 10
- D. Can't determine
Correct Answer: C
Rationale: The therapeutic index (TI) is typically a ratio of the dose causing a toxic effect to the dose producing a therapeutic effect. Without specific data, 10 is a reasonable estimate for a drug with defined dose-response relationships, as per the answer key.
Combined alpha-beta antagonists are used to reduce the progression of heart failure because they:
- A. Vasodilate the peripheral vasculature
- B. Decrease cardiac output
- C. Increase renal vascular resistance
- D. Reduce atherosclerosis secondary to elevated serum lipoproteins
Correct Answer: A
Rationale: Alpha-beta blockers (e.g., carvedilol) vasodilate, reducing afterload in heart failure.
Tetracycline needs to be given on an empty stomach because it chelates with:
- A. Calcium
- B. Magnesium
- C. Iron
- D. All of the above
Correct Answer: D
Rationale: Tetracycline forms insoluble complexes with divalent and trivalent cations (calcium, magnesium, iron), reducing absorption when taken with food containing these elements.