Nokea
A patient has low cardiac output due to poor cardiac function. He is eclematous. Which one of the following should be avoided because it can aggravate cardiac dysfunctions?
- A. Furosemide
- B. Spironolactone
- C. Mannitol
- D. Hydrochlorothiazide
Correct Answer: C
Rationale: The correct answer is C: Mannitol. Mannitol is an osmotic diuretic that can worsen heart failure by increasing plasma volume and exacerbating the workload on the heart. Furosemide (A) and Hydrochlorothiazide (D) are loop and thiazide diuretics, respectively, commonly used to manage fluid overload in heart failure patients. Spironolactone (B) is a potassium-sparing diuretic that can be beneficial in heart failure by counteracting potassium loss caused by other diuretics.
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A nurse is caring for a patient with impaired renal which the nurse should monitor the patient?
- A. Accumulation of wastes
- B. The nurse should facilitate collection of what
- C. Retention of potassium
- D. Depletion of calcium
Correct Answer: A
Rationale: The correct answer is A because impaired renal function can lead to the accumulation of wastes in the body, causing toxicity. Monitoring this is crucial for the patient's overall health. Choice B is incorrect as it does not directly relate to the consequences of impaired renal function. Choice C, retention of potassium, is also incorrect as it is a specific outcome of impaired renal function and not the primary focus of monitoring. Choice D, depletion of calcium, is incorrect as impaired renal function is more likely to lead to hypercalcemia rather than hypocalcemia. Therefore, the nurse should prioritize monitoring the accumulation of wastes in a patient with impaired renal function.
Clavulanic acid is combined with amoxicillin because:
- A. It inhibits beta lactamases that destroy amoxicillin
- B. It prevents renal excretion of amoxicillin
- C. It destroy bacteria that are not destroyed by amoxicillin
- D. It counteracts the adverse effects of amoxicillin
Correct Answer: A
Rationale: The correct answer is A because clavulanic acid is a beta-lactamase inhibitor that protects amoxicillin from being destroyed by beta-lactamases produced by certain bacteria. This allows amoxicillin to effectively kill the bacteria. Choices B, C, and D are incorrect because clavulanic acid does not affect renal excretion, directly destroy bacteria, or counteract adverse effects of amoxicillin.
Which of the following drug adverse reactions precludes a patient from being given the same drug in the future?
- A. GI upset from Clarithromycin
- B. Skin Rash from Ampicillin
- C. Steven-Johnson syndrome from Trimethoprim/Sulfamethoxazole
- D. Clostridium difficile superinfection from Ofloxacin
Correct Answer: C
Rationale: The correct answer is C because Steven-Johnson syndrome is a severe and life-threatening skin reaction that can occur with certain medications like Trimethoprim/Sulfamethoxazole. Once a patient experiences this reaction, they should never be given the same drug again to avoid a potentially fatal outcome. The other choices, GI upset from Clarithromycin, skin rash from Ampicillin, and Clostridium difficile superinfection from Ofloxacin, are adverse reactions that can be managed or treated without completely excluding the drug from future use.
Which is not a relatively common finding in ESRF patients?
- A. Metastatic calcification.
- B. Peripheral neuropathy
- C. Hypophosphatemia
- D. Hyperparathyroidism
Correct Answer: C
Rationale: The correct answer is C: Hypophosphatemia. In end-stage renal failure (ESRF) patients, hypophosphatemia is not a common finding due to impaired renal excretion of phosphate. Metastatic calcification (A) occurs due to high calcium-phosphate product, peripheral neuropathy (B) can result from uremic toxins, and hyperparathyroidism (D) is common in ESRF due to secondary hyperparathyroidism. Therefore, hypophosphatemia is the least likely finding in ESRF patients.
The most frequent side effect of oral ampicillin is : *
- A. Nausea and vomiting
- B. Loose bowel movements
- C. Constipation
- D. Urticaria
Correct Answer: A
Rationale: The correct answer is A: Nausea and vomiting. Oral ampicillin commonly causes gastrointestinal side effects such as nausea and vomiting due to its impact on the gut flora. This side effect is a result of the antibiotic's mechanism of action and is well-documented in clinical practice. Choices B, C, and D are incorrect as loose bowel movements, constipation, and urticaria are not typically associated with oral ampicillin use.