Nokea
A patient who is unconscious arrives in the emergency department with clammy skin and constricted pupils. The nurse assesses a respiratory rate of 8 to 10 breaths per minute. The paramedics report obvious signs of drug abuse in the patient's home. The nurse suspects that this patient has had an overdose of which substance?
- A. Alcohol
- B. LSD
- C. An opioid
- D. Methamphetamine
Correct Answer: C
Rationale: Opioid overdose causes miosis and respiratory depression; alcohol or meth differ. Opioid overdose is characterized by constricted pupils and respiratory depression.
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A nurse is teaching the parents of a child who has a new prescription for Desipramine. The nurse should instruct the parents that which of the following adverse effects is the priority to report to the provider?
- A. Constipation
- B. Suicidal thoughts
- C. Photophobia
- D. Dry mouth
Correct Answer: B
Rationale: Suicidal thoughts are a critical adverse effect of tricyclics like desipramine, requiring immediate reporting.
Immunomodulators such as azathioprine may cause a delayed adverse drug reaction known as a type D reaction because they are known:
- A. Teratogens
- B. Carcinogens
- C. To cause hypersensitivity reactions
- D. Hypothalamus-pituitary-adrenal axis suppressants
Correct Answer: B
Rationale: Azathioprine's Type D (delayed) ADRs, like cancer risk , emerge long-term, unlike teratogenicity , hypersensitivity , or HPA suppression .
Treatment goals in prescribing should:
- A. Always be curative
- B. Be patient-centered
- C. Be convenient for the provider
- D. Focus on the cost of therapy
Correct Answer: B
Rationale: Patient-centered goals prioritize individual needs and outcomes, not just cure , provider convenience , or cost alone .
A nurse is providing instructions to a female client who has a new prescription for Zolpidem. Which of the following instructions should the nurse include?
- A. Notify the provider if you plan to become pregnant.
- B. Take the medication 1 hr before you plan to go to sleep.
- C. Allow at least 6 hr for sleep when taking zolpidem.
- D. To increase the effectiveness of zolpidem, take it with a bedtime snack.
Correct Answer: A
Rationale: Pregnancy notification is key due to zolpidem's risks; it's taken just before sleep, needing 7-8 hours.
Which of the following create a higher risk for digoxin toxicity? Both the cause and the reason for it must be correct.
- A. Older adults because of reduced renal function
- B. Administration of aldosterone antagonist diuretics because of decreased potassium levels
- C. Taking an antacid for gastroesophageal reflux disease because it increases the absorption of digoxin
- D. Doses between 0.25 and 0.5 mg/day
Correct Answer: A
Rationale: Older adults have reduced renal clearance, increasing digoxin toxicity risk.