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A patient has been taking digoxin at home but took an accidental overdose and has developed toxicity. The patient has been admitted to the telemetry unit, where the physician has ordered
- A. . The patient asks the nurse why the medication is ordere
- B. What is the nurse™s best response?
- C. It will increase your heart rat
- D.
Correct Answer: B
Rationale: The correct response is to inform the patient that the medication, likely an antiarrhythmic agent such as digoxin immune fab (Digibind), helps to convert the irregular heart rhythm caused by digoxin toxicity to a more normal rhythm. This explanation provides a clear understanding of why the medication is being administered in cases of digoxin toxicity. It is important for the nurse to educate the patient about the purpose of the medication and how it will help manage the symptoms of digoxin toxicity.
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Which of the following 'overdoses' is most commonly associated with respiratory alkalosis, but when more severe a metabolic acidosis?
- A. Methanol
- B. Lead
- C. Paracetamol
- D. Salicylate
Correct Answer: D
Rationale: Overdose toxicities differ in acid-base effects. Methanol causes metabolic acidosis via formic acid, not respiratory alkalosis. Lead poisoning leads to anemia or neurologic issues, rarely acid-base shifts. Paracetamol overdose induces lactic acidosis from liver failure, not respiratory changes initially. Salicylate (e.g., aspirin) overdose stimulates the respiratory center early, causing hyperventilation and respiratory alkalosis (low pCO2), but severe cases add metabolic acidosis (high anion gap) from uncoupled oxidative phosphorylation and lactic acid buildup. Codeine, an opioid, depresses respiration, causing acidosis, not alkalosis. Salicylate's dual pattern is distinctive, requiring urgent recognition—initial alkalosis shifts to acidosis as toxicity worsens, guiding bicarbonate or dialysis treatment.
Morphine over dose is treated with_____
- A. Naloxone
- B. Vitamin K
- C. Time
- D. Grapefruit juice
Correct Answer: A
Rationale: Morphine overdose is a medical emergency that can result in respiratory depression and potentially lead to death. Naloxone is a medication used to counteract the effects of opioids like morphine by binding to the same receptors in the brain and reversing the respiratory depression. Naloxone works quickly to restore normal breathing and consciousness in individuals who have overdosed on morphine. It is a critical intervention used to prevent fatal outcomes of opioid overdose, including morphine. Other options like Vitamin K, time, and grapefruit juice are not effective treatments for morphine overdose.
A local municipality is alerted that low doses of carbon tetrachloride have been dumped into the drinking water. A public health alert is transmitted to all residents of this town. Which of the following signs and symptoms should these residents be aware of?
- A. Convulsions
- B. Eye irritation
- C. Nausea
- D. Stupor
Correct Answer: C
Rationale: Carbon tetrachloride exposure causes nausea , reflecting GI and hepatic toxicity. Convulsions and stupor occur with high doses. Eye irritation and vomiting (E) are less specific. Low-dose ingestion aligns with nausea as a primary symptom.
What is a side effect of Heparin?
- A. nausea
- B. diarrhea
- C. bleeding
- D. bronchospasms
Correct Answer: C
Rationale: A common side effect of Heparin, which is an anticoagulant medication, is the risk of bleeding. Heparin works by preventing the formation of blood clots, which can lead to a bleeding risk as it inhibits the normal clotting process. Patients taking Heparin should be monitored closely for signs of bleeding, such as easy bruising, prolonged bleeding from minor cuts, or blood in the urine or stools. It is important for healthcare providers to closely monitor patients on Heparin therapy and adjust the dosage as needed to minimize the risk of excessive bleeding.
A 48-year-old woman pricks her finger on a rose bush while pruning. A few days later, she develops small, red lesions near the wound and a red track ascending her hand toward her trunk. Her doctor prescribes itraconazole for the sporotrichosis. What is the mechanism of action of this medication?
- A. Disrupts fungal cell membrane by forming pores (nystatin, amphotericin B)
- B. Disrupts fungal microtubules (griseofulvin)
- C. Inhibits conversion of lanosterol to ergosterol
- D. Inhibits squalene monooxygenase (terbinafine)
Correct Answer: C
Rationale: Sporotrichosis, from Sporothrix schenckii, requires antifungals like itraconazole. Option , inhibiting lanosterol to ergosterol conversion, is correct-itraconazole blocks 14-α-demethylase, disrupting fungal membrane synthesis. Option , pore formation, is amphotericin B's mechanism. Option , microtubule disruption, is griseofulvin's. Option , squalene monooxygenase inhibition, is terbinafine's. Option (E), 5-FU conversion, is flucytosine's. Itraconazole's ergosterol inhibition effectively treats this subcutaneous infection, targeting fungal viability.