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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When involved in phase III drug evaluation studies, what responsibilities would the nurse have?
- A. Working with animals who are given experimental drugs
- B. Choosing appropriate patients to be involved in the drug study
- C. Monitoring and observing patients closely for adverse effects
- D. Conducting research to determine effectiveness of the drug
Correct Answer: C
Rationale: Phase III studies involve use of a drug in a vast clinical population in which patients are asked to record any symptoms they experience while taking the drugs. Nurses may be responsible for helping collect and analyze the information to be shared with the Food and Drug Administration (FDA) but would not conduct research independently because nurses do not prescribe medications. Use of animals in drug testing is done in the preclinical trials. Select patients who are involved in phase II studies to participate in studies where the participants have the disease the drug is intended to treat. These patients are monitored closely for drug action and adverse effects. Phase I studies involve healthy human volunteers who are usually paid for their participation. Nurses may observe for adverse effects and toxicity.
Which of the following adverse effects of chronic high-dose prednisone administration represents a mineralocorticoid effect?
- A. Buffalo hump
- B. Easy bruising
- C. Edema
- D. Moon facies
Correct Answer: C
Rationale: Edema is a mineralocorticoid effect of prednisone due to sodium and water retention.
Which of the following is the most frequent cause of weight loss and decrease of apetite:
- A. While using insulin medications
- B. While treated with acarbose
- C. While treated with metformin
- D. While treated with glibenclamid
Correct Answer: C
Rationale: Metformin often causes weight loss and reduced appetite as a side effect due to its effects on metabolism and gastrointestinal function.
A patient has recently moved from Vermont to Southern Florida. The patient presents to the clinic complaining of dizzy spells and weakness. While conducting the admission assessment, the patient tells the nurse that he have been on the same antihypertensive drug for 6 years and had stable blood pressures and no adverse effects. Since his move, he has been having problems and he feels that the drug is no longer effective. The clinic nurse knows that one possible reason for the change in the effectiveness of the drug could be what?
- A. The impact of the placebo effect on the patients response.
- B. The accumulative effect of the drug if it has been taken for many years.
- C. The impact of the warmer environment on the patients physical status.
- D. Problems with patient compliance with the drug regimen while on vacation.
Correct Answer: C
Rationale: Antihypertensive drugs work to decrease the blood pressure. When a patient goes to a climate that is much warmer than usual, blood vessels dilate and the blood pressure falls. If a patient is taking an antihypertensive drug and moves to a warmer climate, there is a chance that the patients blood pressure will drop too low, resulting in dizziness and feelings of weakness. Even mild dehydration could exacerbate these effects. Most antihypertensives are metabolized and excreted and do not accumulate in the body. Patients must be very compliant with their drug regimen on vacation. After several years on an antihypertensive drug, the effects of that drug are known; therefore, the placebo effect should not be an issue.
Which phenothiazine has the least extra pyramidal effect
- A. Thioridazine
- B. Chlorpromazine
- C. Triflupromazine
- D. Fluphenazine
Correct Answer: A
Rationale: Thioridazine has fewer extrapyramidal effects.