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A patient is admitted to the emergency department with severe recurrent convulsive seizures. Would the nurse expect to order for the use in emergency control of status epileptic?
- A. Ethosuximide (Zarontin).
- B. Diazepam (Valium).
- C. Phenobarbital (Luminal).
- D. Phenytoin (Dilantin).
Correct Answer: B
Rationale: The correct answer is B: Diazepam (Valium). In emergency situations of status epilepticus, diazepam is the preferred medication for immediate control of seizures due to its fast onset of action and efficacy in stopping prolonged seizures. Diazepam acts by enhancing the effect of gamma-aminobutyric acid (GABA) in the brain, which inhibits excessive neuronal activity. Ethosuximide (A) is used for absence seizures, not convulsive seizures. Phenobarbital (C) and phenytoin (D) have slower onset of action and are not ideal for immediate control of seizures.
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The nurse is preparing to assist with blood collection on a newly admitted patient who has been taking phenytoin for several years. The provider has ordered a complete blood count and liver function tests. Which other blood test will the nurse discuss with the provider?
- A. Coagulation studies.
- B. Serum electrolytes.
- C. Renal function tests.
- D. Blood glucose.
Correct Answer: D
Rationale: The correct answer is D: Blood glucose. Phenytoin can potentially affect blood glucose levels by causing hyperglycemia. Monitoring blood glucose levels is important to ensure the patient's safety and adjust medication dosages if needed.
Other choices are incorrect:
A: Coagulation studies are not typically affected by phenytoin therapy.
B: Serum electrolytes may need monitoring for other reasons, but not specifically related to phenytoin use.
C: Renal function tests are important for monitoring kidney function but are not directly influenced by phenytoin.
The nurse is caring for a patient who is receiving a high dose of intravenous azithromycin to treat an infection. The patient is also taking acetaminophen for pain. The nurse should expect to review which lab value when monitoring for this drug side effect?
- A. Complete blood count.
- B. Urinalysis.
- C. Electrolytes.
- D. Liver enzymes.
Correct Answer: D
Rationale: The correct answer is D: Liver enzymes. Azithromycin can cause liver toxicity as a side effect. Monitoring liver enzymes such as AST and ALT levels is crucial to detect any signs of liver damage. Acetaminophen is also metabolized in the liver, so combining it with azithromycin may increase the risk of liver injury. Checking liver enzymes helps the nurse assess the patient's liver function and adjust the medication regimen if necessary.
A: Complete blood count is not typically affected by azithromycin or acetaminophen.
B: Urinalysis is not relevant for monitoring liver toxicity.
C: Electrolytes are important but not specifically related to the side effects of azithromycin or acetaminophen in this scenario.
The telephone triage nurse receives a call from a patient asking for a prescription for a narcotic to manage his surgical pain. The nurse explains that narcotic prescriptions must be written and cannot be called in to the pharmacy. The patient says, “Why are narcotics so difficult to get a prescription for?†What is the nurse's best response?
- A. The increase in the number of drug addicts has made the rules stricter.
- B. Controlled substances like narcotics are regulated by the FDA and the DEA.
- C. The Centers for Disease Control and Prevention regulates the use of controlled substances to reduce the risk of injury.
- D. The Drug Enforcement Agency (DEA) determines the risk for addiction, and the Food and Drug Administration enforces this control.
Correct Answer: B
Rationale: The correct answer is B: Controlled substances like narcotics are regulated by the FDA and the DEA. The FDA (Food and Drug Administration) regulates the approval, manufacturing, and labeling of prescription medications, including narcotics, to ensure they are safe and effective for use. The DEA (Drug Enforcement Administration) enforces regulations surrounding controlled substances to prevent misuse and abuse. This response is the best choice as it directly addresses the regulatory bodies responsible for overseeing the prescription and dispensing of narcotics.
Incorrect Choices:
A: The increase in the number of drug addicts has made the rules stricter. This choice provides a general statement about the rules without addressing the specific regulatory bodies involved in controlling narcotics.
C: The Centers for Disease Control and Prevention regulates the use of controlled substances to reduce the risk of injury. Although the CDC plays a role in public health, it is not the primary regulatory agency for controlled substances.
D: The Drug Enforcement Agency (DEA) determines the risk for addiction, and the Food and Drug Administration
What assessment finding would indicate the patient's left-sided heart failure is worsening?
- A. Increased jugular venous pressure.
- B. Liver enlargement.
- C. Increased pulse rate.
- D. Increased crackles in lung fields.
Correct Answer: D
Rationale: The correct answer is D: Increased crackles in lung fields. Worsening left-sided heart failure causes fluid to accumulate in the lungs, leading to crackles on auscultation. Increased jugular venous pressure (A) is more indicative of right-sided heart failure. Liver enlargement (B) is a sign of congestive hepatomegaly, common in right-sided heart failure. Increased pulse rate (C) may indicate heart failure exacerbation but is not specific to left-sided failure. Therefore, choice D is the best indicator of worsening left-sided heart failure.
What is the action of the thiazide diuretic?
- A. Blocks the sodium pump.
- B. Block the chloride pump.
- C. Blocks the carbonic anhydrase pump.
- D. Blocks the potassium pump.
Correct Answer: B
Rationale: The correct answer is B: Blocks the chloride pump. Thiazide diuretics inhibit the sodium-chloride symporter in the distal convoluted tubule of the nephron, leading to increased excretion of sodium and chloride ions, resulting in diuresis. Choice A is incorrect as thiazides do not block the sodium pump. Choice C is incorrect as carbonic anhydrase inhibitors, not thiazides, block the carbonic anhydrase enzyme. Choice D is incorrect as thiazides do not block the potassium pump.