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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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Therapeutic index of a drug is an indicator of
- A. Potency
- B. Safety
- C. Toxicity
- D. Efficacy
Correct Answer: C
Rationale: Therapeutic index (TD50/ED50) measures the margin between therapeutic and toxic doses.
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.
A patient with Type 2 diabetes mellitus begins gaining weight after several months of therapy with an oral antidiabetic agent. A complete workup indicates edema and other signs and symptoms of heart failure. Which of the following antidiabetic drug or group was the most likely cause?
- A. Acarbose
- B. Biguanides
- C. Glitazones (thiazolidinediones, such as rosiglitazone)
- D. Metformin
Correct Answer: C
Rationale: Glitazones like rosiglitazone can cause fluid retention and weight gain, increasing the risk of heart failure.
In today's healthcare environment there is often more contact between the patient and the nurse than between the patient and the physician. What does this make the nurse in the best position to do?
- A. Assess the patient's inability to document medication taken
- B. Assess the patient's inability to communicate with caregivers
- C. Assess the therapeutic success of the drug therapy
- D. Assess the patient's reluctance to purchase the prescribed drug
Correct Answer: C
Rationale: Frequent contact positions nurses to evaluate drug therapy success through direct observation and patient feedback.
A contraindication for topical corticosteroid usage in a male with atopic dermatitis (eczema) is:
- A. Parasite infection
- B. Viral infection
- C. Bacterial infection
- D. Spirochete infection
Correct Answer: B
Rationale: Topical corticosteroids worsen viral infections (e.g., herpes) due to immunosuppression.