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A patient arrives in the emergency department in an acute state of alcohol intoxication and reports chronic consumption of several six packs of beer every day for the past year. The nurse anticipates administering which medication or treatment?
- A. Chlordiazepoxide (Librium)
- B. Disulfiram (Antabuse)
- C. Gastric lavage
- D. Vasoconstrictors
Correct Answer: A
Rationale: Chlordiazepoxide prevents alcohol withdrawal symptoms; disulfiram is post-detox. To prevent acute withdrawal and delirium tremens, a long-acting benzodiazepine, such as chlordiazepoxide, is given.
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Charlie is a 65-year-old male who has been diagnosed with hypertension and benign prostatic hyperplasia. Doxazosin has been chosen to treat his hypertension because it:
- A. Increases peripheral vasoconstriction
- B. Decreases detrusor muscle contractility
- C. Lowers supine blood pressure more than standing pressure
- D. Relaxes smooth muscle in the bladder neck
Correct Answer: D
Rationale: Doxazosin, an alpha-1 blocker, relaxes bladder neck smooth muscle, aiding BPH, and lowers blood pressure.
A community health nurse visits a client at home. Prednisone 10 mg orally daily has been prescribed for the client and the nurse reinforces teaching for the client about the medication. Which statement, if made by the client, indicates that further teaching is necessary?
- A. I can take aspirin or my antihistamine if I need it.'
- B. I need to take the medication every day at the same time.'
- C. I need to avoid coffee, tea, cola, and chocolate in my diet.'
- D. If I gain more than 5 pounds a week, I will call my doctor.'
Correct Answer: A
Rationale: Aspirin and other over-the-counter medications should not be taken unless the client consults with the health care provider (HCP). The client needs to take the medication at the same time every day and should be instructed not to stop the medication. A slight weight gain as a result of an improved appetite is expected, but after the dosage is stabilized, a weight gain of 5 lb or more weekly should be reported to the HCP. Caffeine-containing foods and fluids need to be avoided because they may contribute to steroid-ulcer development.
Being competent in the use of information technology in clinical practice is expected in professional nurses. Advanced practice competence includes the ability to:
- A. Search for information using the most common search engines
- B. Serve as content experts in developing, implementing, and evaluating information systems
- C. Write programs to assure the integrity of health information
- D. Use information technology to prescribe drugs
Correct Answer: B
Rationale: Advanced practice nurses contribute expertise in IT system development and evaluation.
Amphetamine should not be taken with.....
- A. Paracetamol
- B. Aspirin
- C. MAO inhibitors
- D. Benzimidazole
Correct Answer: C
Rationale: Amphetamines combined with MAO inhibitors can cause a hypertensive crisis due to excessive catecholamine accumulation, a well-known dangerous interaction.
Drugs do not metabolize the same way in all people. For what patient would a nurse expect to assess for an alteration in drug metabolism?
- A. A 35-year-old woman with cervical cancer
- B. A 41-year-old man with kidney stones
- C. A 50-year-old man with cirrhosis of the liver
- D. A 62-year-old woman in acute renal failure
Correct Answer: C
Rationale: The liver is the most important site of drug metabolism. If the liver is not functioning effectively, as in patients with cirrhosis, drugs will not metabolize normally so that toxic levels could develop unless dosage is reduced. A patient with cervical cancer or kidney stones would not be expected to have altered ability to metabolize drugs so long as no liver damage existed. The patient with renal failure would have altered excretion of the drugs through the renal system but metabolism would not be impacted.