Nokea
A patient is prescribed lidocaine for ventricular arrhythmias. Which side effect should the nurse monitor for?
- A. Hypotension
- B. Nausea
- C. Seizures
- D. Bradycardia
Correct Answer: C
Rationale: Lidocaine, a Class IB antiarrhythmic, can cause CNS side effects like seizures at high doses, a key monitoring point.
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Mechanisms of transmembrane signaling are the following EXCEPT:
- A. Transmembrane receptors that bind and stimulate a protein tyrosine kinase
- B. Gene replacement by the introduction of a therapeutic gene to correct a genetic effect
- C. Ligand-gated ion channels that can be induced to open or close by binding a ligand
- D. Transmembrane receptor protein that stimulates a GTP-binding signal transducer protein (G-protein) which in turn generates an intracellular second messenger
Correct Answer: B
Rationale: Gene replacement is a therapeutic strategy, not a signaling mechanism.
What does the nurse understand must occur in order to produce withdrawal syndrome?
- A. Addiction
- B. Craving
- C. Drug tolerance
- D. Physical dependence
Correct Answer: D
Rationale: Physical dependence causes withdrawal when a drug stops; addiction or tolerance don't suffice. Patients who develop a physical dependence on a drug will experience withdrawal syndrome when the drug is stopped.
Which of the following is a disadvantage of IM administration?
- A. Larger volumes can be used
- B. Can affect lab tests
- C. Painful
- D. B and C
Correct Answer: C
Rationale: Intramuscular (IM) administration is painful due to needle insertion, though larger volumes are an advantage; affecting lab tests is less specific, making C the primary disadvantage.
The nurse explains the Drug Enforcement Agency's (DEA's) schedule of controlled substances to the nursing assistant who asks, Do you ever get a prescription for Schedule I medications? What is the nurse's best response?
- A. Schedule I medications have no medical use so they are not prescribed.
- B. Schedule I medications have the lowest risk for abuse and do not require a prescription.
- C. Schedule I medications are only prescribed in monitored units for patient safety.
- D. Schedule I medications are found in antitussives and antidiarrheals sold over the counter.
Correct Answer: A
Rationale: Schedule I medications have no medical use and are never prescribed. Schedule V medications have the lowest risk for abuse and are found mostly in antitussives and antidiarrheals but they are not sold over the counter.
When patients are started on darbepoetin alfa (Aranesp) they need monitoring of their blood counts to determine a dosage adjustment in:
- A. 6 weeks if they are a cancer patient
- B. 1 week if they have chronic renal failure
- C. 2 weeks if they are taking it for allogenic transfusion
- D. Each week throughout therapy
Correct Answer: A
Rationale: Cancer patients need blood count checks at 6 weeks for darbepoetin adjustment; renal patients adjust sooner, typically 2-4 weeks.