Nokea
A patient comes to the ER having his quadriceps muscle constantly contracted, you should give him:
- A. Norepinephrine to stimulate the sympathetic nervous system
- B. An antagonist for Norepinephrine
- C. Agonist for acetylcholine
- D. Both B and C
Correct Answer: D
Rationale: Both B and C are correct: a norepinephrine antagonist (e.g., beta-blocker) or acetylcholine agonist (e.g., to relax via parasympathetic action) could relieve muscle contraction.
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What does the nurse understand must occur in order to produce withdrawal syndrome?
- A. Addiction
- B. Craving
- C. Drug tolerance
- D. Physical dependence
Correct Answer: D
Rationale: Physical dependence causes withdrawal when a drug stops; addiction or tolerance don't suffice. Patients who develop a physical dependence on a drug will experience withdrawal syndrome when the drug is stopped.
When patients are started on darbepoetin alfa (Aranesp) they need monitoring of their blood counts to determine a dosage adjustment in:
- A. 6 weeks if they are a cancer patient
- B. 1 week if they have chronic renal failure
- C. 2 weeks if they are taking it for allogenic transfusion
- D. Each week throughout therapy
Correct Answer: A
Rationale: Cancer patients need blood count checks at 6 weeks for darbepoetin adjustment; renal patients adjust sooner, typically 2-4 weeks.
Secobarbital and ethanol when given together show:
- A. Additive sedative action
- B. Reduced sedative action
- C. Competitive antagonism
- D. Chemical antagonism
Correct Answer: A
Rationale: Both secobarbital (barbiturate) and ethanol are CNS depressants, resulting in additive sedation.
You are doing an admission assessment on a patient. During the medication history portion of the assessment what would be important to assess with herbal supplements?
- A. Research them for interactions with other medications
- B. Discontinue them if taking prescription medications
- C. Take them one hour before prescription medications
- D. Take them three hours after prescription medications
Correct Answer: A
Rationale: Researching herbal interactions ensures safe integration with prescribed drugs, preventing adverse effects.
The physician has asked a nurse to administer a drug intravenously to a patient who is unresponsive. How can the nurse ensure that the drug is administered to the right patient?
- A. By waking him up to ask him his name
- B. By identifying the patient's room number
- C. By checking the patient's wristband
- D. By asking the nursing assistant for the patient's location
Correct Answer: C
Rationale: The nurse should identify a patient by checking his wristband, which has the patient's name. The nurse should not ask the patient to confirm his name, because some patients, particularly those who are confused or have difficulty hearing, may respond by answering yes. Additionally, this patient is unresponsive. The nurse can obtain the patient's location by asking any other member of the health care staff, but should verify the patient's identity by checking the wristband. The nurse should not rely on the patient's room number alone.