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).
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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 32-year-old female is admitted to your unit with a diagnosis of hypovolemia. You are writing a care plan for this patient. You know that an appropriate nursing diagnosis to help prevent medication errors is what?
- A. Dysfunctional gastrointestinal motility
- B. Ineffective self health maintenance
- C. Risk for injury
- D. Deficient fluid volume
Correct Answer: D
Rationale: Hypovolemia aligns with 'Deficient fluid volume,' guiding drug therapy to correct volume status and prevent errors.
A patient is being seen in the clinic for rheumatoid arthritis. Which of the following statements would indicate that she may be developing a complication from her rheumatoid medication, chloroquine (Aralen)?
- A. I have to urinate all the time.'
- B. Sometimes I have blurred vision.'
- C. I have tingling and numbness in my arms and legs.'
- D. Sometimes I feel like I am losing my balance when I walk.'
Correct Answer: B
Rationale: Chloroquine (Aralen) can cause ocular toxicity with blurring of vision, color vision changes, corneal damage, and blindness. Increased urination and tingling and numbness are signs of hyperkalemia and hypokalemia. Loss of balance can be caused by auditory damage due to drug toxicity.
Which of the following drugs is used for the management of atropine intoxication?
- A. Physostigmine
- B. Neostigmine
- C. Endrophonium
- D. Donepezil
Correct Answer: A
Rationale: Physostigmine, a cholinesterase inhibitor, crosses the BBB to reverse atropine's central effects.
Following are the sign and symptoms of acute morphine poisoning EXCEPT
- A. Respiratory depression with shallow breathing
- B. Hyperthermia
- C. Pin-point pupil
- D. Hypotension
Correct Answer: B
Rationale: Acute morphine poisoning typically causes respiratory depression, miosis (pin-point pupils), and hypotension, but hypothermia, not hyperthermia, is common due to opioid-induced CNS depression.