Nokea
A patient with a history of opioid abuse will be discharged home with buprenorphine to help prevent relapse. Which product will the nurse anticipate the provider to order?
- A. Buprenex
- B. Suboxone
- C. Subutex
- D. Vivitrol
Correct Answer: A
Rationale: Buprenex is buprenorphine with low abuse potential for maintenance; Suboxone has naloxone added. Buprenex is an agonist-antagonist opioid that can be used for detoxification and maintenance therapy because it has a low potential for abuse.
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An example of a first-dose reaction that may occur includes:
- A. Orthostatic hypotension that does not occur with repeated doses
- B. Purple glove syndrome with phenytoin use
- C. Hemolytic anemia from ceftriaxone use
- D. Contact dermatitis from neomycin use
Correct Answer: C
Rationale: Hemolytic anemia from ceftriaxone can occur after the first dose as a Type II reaction, unlike orthostatic hypotension (A, adaptive) or others (B, D, later onset).
The nurse is preparing a medication that is new to the market and cannot be found in the nurse's drug guide. Where can the nurse get the most reliable information about this medication?
- A. Package insert
- B. Another nurse
- C. Drug manufacturer
- D. Physician
Correct Answer: A
Rationale: The most reliable information about the drug can be found on the package insert supplied by the manufacturer because it was prepared according to strict Food and Drug Administration (FDA) regulations. Asking another nurse or the physician is not reliable and cannot be verified as accurate. It would not be realistic to call the drug manufacturer for information.
A patient who is taking isoniazid (INH) as part of a two-drug tuberculosis treatment regimen reports tingling of the fingers and toes. The nurse will recommend discussing which treatment with the provider?
- A. Adding pyrazinamide
- B. Changing to ethambutol
- C. Increasing oral fluid intake
- D. Taking pyridoxine (B6)
Correct Answer: D
Rationale: Pyridoxine prevents INH-induced neuropathy (tingling); changing drugs or fluids doesn't address this. Peripheral neuropathy is an adverse reaction to INH, so pyridoxine is usually given to prevent this.
When taken with aminoglycosides, platinum chemotherapy or cyclosporin increase the risk of
- A. Kidney damage
- B. Ototoxicity
Correct Answer: A
Rationale: Platinum chemotherapy (e.g., cisplatin) and cyclosporin both potentiate aminoglycoside nephrotoxicity, increasing kidney damage risk.
In the presence of picrotoxin, diazepam is less efficacious at causing sedation, regardless of the dose. Picrotoxin by it self has no sedative effect even at the highest dose. Which of the following is correct?
- A. Picrotoxin is not a competitive antagonist
- B. Diazepam is a full agonist, and picrotoxin is a partial agonist
- C. Diazepam is less efficacious than is picrotoxin
- D. Diazepam is less potent than is picrotoxin
Correct Answer: A
Rationale: Picrotoxin reduces diazepam's maximal effect (efficacy), not potency, indicating noncompetitive antagonism.