Nokea
A patient with a new onset of systolic ejection murmur should be assessed for which nutritional deficiency?
- A. Vitamin B12
- B. Vitamin C
- C. Folate
- D. Niacin
Correct Answer: A
Rationale: Vitamin B12 deficiency can lead to anemia, potentially causing a systolic murmur.
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Amiodarone has been prescribed in a patient with a supraventricular dysrhythmia. Patient teaching should include all of the following EXCEPT:
- A. Notify your health-care provider immediately if you have visual change.
- B. Monitor your own blood pressure and pulse daily.
- C. Take a hot shower or bath if you feel dizzy.
- D. Use a sunscreen on exposed body surfaces.
Correct Answer: C
Rationale: Hot showers can worsen amiodarone-induced hypotension, not help it.
The home health nurse is caring for a 77-year-old patient with congestive heart failure. What would the nurse consider a priority to assess to develop the most effective plan of care related to medication administration?
- A. Description of the patient's living environment
- B. Required lifestyle changes
- C. Family members in the community
- D. Compliance with therapy to reduce risk of skin breakdown
Correct Answer: A
Rationale: Living environment affects medication storage, access, and administration, critical for an elderly patient with CHF.
A nurse is caring for a patient taking multiple drugs and is concerned about a possible drug-drug interaction. What is the nurse's first and best means of avoiding this problem?
- A. Consult a drug guide.
- B. Call the pharmacist.
- C. Contact the provider.
- D. Ask another nurse.
Correct Answer: A
Rationale: Whenever two or more drugs are being given together, first consult a drug guide for a listing of clinically significant drug-drug interactions. Sometimes problems can be avoided by staggering the administration of the drugs or adjusting their dosages. Consulting the pharmacist is not wrong, but it would not be the first action to take. The nurse holds responsibility for his or her own practice so asking a health care provider or another nurse is based on the assumption that that professional is knowledgeable about all drug-drug interactions, which is likely not the case.
The following drug may be used to relieve bladder spasm after urologic surgery:
- A. Atropine
- B. Dicyclomine
- C. Glycopyrrolate
- D. Oxybutynin
Correct Answer: D
Rationale: Oxybutynin, an antimuscarinic, reduces bladder spasms.
For the treatment of morphine addiction which of the following drug is substituted?
- A. Tramadol
- B. Methadone
- C. Fluoxetine
- D. Dextromethorphan
Correct Answer: B
Rationale: Methadone, a long-acting opioid agonist, is commonly substituted for morphine in addiction treatment to reduce withdrawal symptoms and cravings.