Nokea
Adrenal function is affected by the drug ketoconazole (Nizoral), an antifungal agent used to treat severe fungal infections. How is this effect manifested?
- A. Ketoconazole suppresses adrenal steroid secretion.
- B. Ketoconazole destroys adrenocortical cells, resulting in a 'medical' adrenalectomy.
- C. Ketoconazole increases adrenocorticotropic hormone (ACTH)-induced corticosteroid serum levels.
- D. Ketoconazole decreases duration of adrenal suppression when administered with corticosteroids.
Correct Answer: A
Rationale: Ketoconazole inhibits adrenal steroid synthesis, reducing cortisol production, which can be therapeutic in Cushing's disease.
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Which of the following factors assists a person to achieve positive bereavement outcomes?
- A. Young age.
- B. History of anxiety.
- C. History of depression.
- D. Higher socioeconomic status.
Correct Answer: D
Rationale: Higher socioeconomic status provides access to resources (e.g., counseling, support groups), which can facilitate positive bereavement outcomes.
An apartment fire spreads to seven apartment units. Victims suffer burns, minor injuries, and broken bones from jumping from windows. Which client should be transported first?
- A. A woman who is 5 months pregnant with no apparent injuries.
- B. A middle-aged man with no injuries who has rapid respirations and coughs.
- C. A 10-year-old with a simple fracture of the humerus who is in severe pain.
- D. A 20-year-old with first-degree burns on her hands and forearms.
Correct Answer: B
Rationale: Rapid respirations and coughing suggest possible smoke inhalation, which can lead to airway compromise and requires urgent evaluation and transport.
When the nurse administers I.V. midazolam hydrochloride (Versed), the client demonstrates signs of an overdose. The nurse should next collaborate with the surgical team to:
- A. Ventilate with an oxygenated Ambu bag.
- B. Shock the client with ECG paddles.
- C. Administer 0.5 mL 1:1000 epinephrine.
- D. Titrate flumazenil (Romazicon).
Correct Answer: D
Rationale: Flumazenil is the specific reversal agent for benzodiazepine overdose, such as with midazolam. Titrating flumazenil reverses sedation and respiratory depression effectively.
The nurse is conducting a health screening at a local health fair. Which of the following should the nurse recognize as an increased risk for developing primary open-angle glaucoma? Select all that apply.
- A. Blue eyes
- B. Older age
- C. African ethnicity
- D. Diabetes mellitus
- E. Use of contact lenses
Correct Answer: B,C,D
Rationale: Older age, African ethnicity, and diabetes mellitus are known risk factors for primary open-angle glaucoma due to increased intraocular pressure susceptibility. Blue eyes and contact lens use are not established risk factors.
The nurse has reinforced education at a conference on intramuscular (IM) injections. Which of the following statements by the participant would indicate a correct understanding of the teaching?
- A. "1 mL is the maximum volume in a single site for small children and older infants."
- B. "Depress the plunger as the needle is being inserted into the client's skin to minimize discomfort."
- C. "Insert the needle quickly using a dart-like motion at a 60-degree angle."
- D. "Injecting in the ventrogluteal muscle is more painful than the vastus lateralis."
Correct Answer: A
Rationale: The maximum volume for IM injections in small children and older infants is 1 mL to prevent tissue damage; other options contain incorrect techniques or assumptions.