Nokea
A patient is brought to the emergency department after ingesting an overdose of lorazepam (Ativan) several hours prior. The patient has a respiratory rate of 6 to 10 breaths per minute and is unconscious. The nurse will prepare to perform which action?
- A. Administer activated charcoal
- B. Give flumazenil (Romazicon)
- C. Give naloxone (Narcan)
- D. Perform gastric lavage
Correct Answer: B
Rationale: Flumazenil reverses benzodiazepine (lorazepam) overdose; naloxone is for opioids. Flumazenil is the antidote for benzodiazepine overdose.
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A nurse has received an order to administer two drugs at the same time of the day. The nurse should first:
- A. Wash her hands before handling the medications
- B. Consult a drug guide for compatibility
- C. Question the patient concerning drug allergies
- D. Identify the patient by checking the armband and asking the patient to state his or her name
Correct Answer: B
Rationale: Consulting a drug guide for compatibility is critical to avoid adverse interactions when administering two drugs simultaneously. Hand washing, allergy checks, and patient identification are also essential but follow ensuring drug compatibility to prevent harm.
What needs to happen to the protein-drug complex for the drugs to reach the cells where the drug can act?
- A. The protein-drug complex must break itself into smaller pieces to enter the capillaries.
- B. The binding site on the protein picks up a chemical to make it soluble in the serum.
- C. The drug must break away from the protein-binding site and float freely.
- D. The drug must be dissolved in the plasma so it can enter the capillaries and then the tissues.
Correct Answer: C
Rationale: Most drugs are bound, to some extent, to proteins in the blood to be carried into circulation. The protein-drug complex is relatively large and cannot enter into capillaries and then into tissues to react. The drug must be freed from the protein's binding site at the tissues. This occurs without the introduction of another chemical or by dissolving in it plasma.
The adverse event of thiazolidinedione's is:
- A. Water retention and edema
- B. Weight loss
- C. Facilitation of rhinitis and upper respiratory tract infection
- D. Pancreatitis
Correct Answer: A
Rationale: Thiazolidinediones like pioglitazone cause water retention and edema, increasing heart failure risk.
A nurse is preparing to administer tobramycin. Which lab value should be monitored closely?
- A. Liver function tests
- B. BUN and creatinine
- C. Complete blood count
- D. Electrolytes
Correct Answer: B
Rationale: Tobramycin, an aminoglycoside, is nephrotoxic; BUN and creatinine monitor kidney function, critical for safe administration.
The therapeutic goals when prescribing include(s):
- A. Curative
- B. Palliative
- C. Preventive
- D. All of the above
Correct Answer: D
Rationale: Therapeutic goals can be curative, palliative, or preventive , depending on the patient's condition and needs.